notes on nursing: what it is, and what it is not. by florence nightingale. london: harrison, , pall mall, bookseller to the queen. [_the right of translation is reserved._] printed by harrison and sons, st. martin's lane, w.c. preface. the following notes are by no means intended as a rule of thought by which nurses can teach themselves to nurse, still less as a manual to teach nurses to nurse. they are meant simply to give hints for thought to women who have personal charge of the health of others. every woman, or at least almost every woman, in england has, at one time or another of her life, charge of the personal health of somebody, whether child or invalid,--in other words, every woman is a nurse. every day sanitary knowledge, or the knowledge of nursing, or in other words, of how to put the constitution in such a state as that it will have no disease, or that it can recover from disease, takes a higher place. it is recognized as the knowledge which every one ought to have--distinct from medical knowledge, which only a profession can have. if, then, every woman must, at some time or other of her life, become a nurse, i.e., have charge of somebody's health, how immense and how valuable would be the produce of her united experience if every woman would think how to nurse. i do not pretend to teach her how, i ask her to teach herself, and for this purpose i venture to give her some hints. table of contents. pages ventilation and warming health of houses petty management noise variety taking food what food? bed and bedding light cleanliness of rooms and walls personal cleanliness chattering hopes and advices observation of the sick conclusion appendix notes on nursing: what it is, and what it is not. [sidenote: disease a reparative process.] shall we begin by taking it as a general principle--that all disease, at some period or other of its course, is more or less a reparative process, not necessarily accompanied with suffering: an effort of nature to remedy a process of poisoning or of decay, which has taken place weeks, months, sometimes years beforehand, unnoticed, the termination of the disease being then, while the antecedent process was going on, determined? if we accept this as a general principle we shall be immediately met with anecdotes and instances to prove the contrary. just so if we were to take, as a principle--all the climates of the earth are meant to be made habitable for man, by the efforts of man--the objection would be immediately raised,--will the top of mont blanc ever be made habitable? our answer would be, it will be many thousands of years before we have reached the bottom of mont blanc in making the earth healthy. wait till we have reached the bottom before we discuss the top. [sidenote: of the sufferings of disease, disease not always the cause.] in watching disease, both in private houses and in public hospitals, the thing which strikes the experienced observer most forcibly is this, that the symptoms or the sufferings generally considered to be inevitable and incident to the disease are very often not symptoms of the disease at all, but of something quite different--of the want of fresh air, or of light, or of warmth, or of quiet, or of cleanliness, or of punctuality and care in the administration of diet, of each or of all of these. and this quite as much in private as in hospital nursing. the reparative process which nature has instituted and which we call disease has been hindered by some want of knowledge or attention, in one or in all of these things, and pain, suffering, or interruption of the whole process sets in. if a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault not of the disease, but of the nursing. [sidenote: what nursing ought to do.] i use the word nursing for want of a better. it has been limited to signify little more than the administration of medicines and the application of poultices. it ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet--all at the least expense of vital power to the patient. [sidenote: nursing the sick little understood.] it has been said and written scores of times, that every woman makes a good nurse. i believe, on the contrary, that the very elements of nursing are all but unknown. by this i do not mean that the nurse is always to blame. bad sanitary, bad architectural, and bad administrative arrangements often make it impossible to nurse. but the art of nursing ought to include such arrangements as alone make what i understand by nursing, possible. the art of nursing, as now practised, seems to be expressly constituted to unmake what god had made disease to be, viz., a reparative process. [sidenote: nursing ought to assist the reparative process.] to recur to the first objection. if we are asked, is such or such a disease a reparative process? can such an illness be unaccompanied with suffering? will any care prevent such a patient from suffering this or that?--i humbly say, i do not know. but when you have done away with all that pain and suffering, which in patients are the symptoms not of their disease, but of the absence of one or all of the above-mentioned essentials to the success of nature's reparative processes, we shall then know what are the symptoms of and the sufferings inseparable from the disease. another and the commonest exclamation which will be instantly made is--would you do nothing, then, in cholera, fever, &c.?--so deep-rooted and universal is the conviction that to give medicine is to be doing something, or rather everything; to give air, warmth, cleanliness, &c., is to do nothing. the reply is, that in these and many other similar diseases the exact value of particular remedies and modes of treatment is by no means ascertained, while there is universal experience as to the extreme importance of careful nursing in determining the issue of the disease. [sidenote: nursing the well.] ii. the very elements of what constitutes good nursing are as little understood for the well as for the sick. the same laws of health or of nursing, for they are in reality the same, obtain among the well as among the sick. the breaking of them produces only a less violent consequence among the former than among the latter,--and this sometimes, not always. it is constantly objected,--"but how can i obtain this medical knowledge? i am not a doctor. i must leave this to doctors." [sidenote: little understood.] oh, mothers of families! you who say this, do you know that one in every seven infants in this civilized land of england perishes before it is one year old? that, in london, two in every five die before they are five years old? and, in the other great cities of england, nearly one out of two?[ ] "the life duration of tender babies" (as some saturn, turned analytical chemist, says) "is the most delicate test" of sanitary conditions. is all this premature suffering and death necessary? or did nature intend mothers to be always accompanied by doctors? or is it better to learn the piano-forte than to learn the laws which subserve the preservation of offspring? macaulay somewhere says, that it is extraordinary that, whereas the laws of the motions of the heavenly bodies, far removed as they are from us, are perfectly well understood, the laws of the human mind, which are under our observation all day and every day, are no better understood than they were two thousand years ago. but how much more extraordinary is it that, whereas what we might call the coxcombries of education--e.g., the elements of astronomy--are now taught to every school-girl, neither mothers of families of any class, nor school-mistresses of any class, nor nurses of children, nor nurses of hospitals, are taught anything about those laws which god has assigned to the relations of our bodies with the world in which he has put them. in other words, the laws which make these bodies, into which he has put our minds, healthy or unhealthy organs of those minds, are all but unlearnt. not but that these laws--the laws of life--are in a certain measure understood, but not even mothers think it worth their while to study them--to study how to give their children healthy existences. they call it medical or physiological knowledge, fit only for doctors. another objection. we are constantly told,--"but the circumstances which govern our children's healths are beyond our control. what can we do with winds? there is the east wind. most people can tell before they get up in the morning whether the wind is in the east." to this one can answer with more certainty than to the former objections. who is it who knows when the wind is in the east? not the highland drover, certainly, exposed to the east wind, but the young lady who is worn out with the want of exposure to fresh air, to sunlight, &c. put the latter under as good sanitary circumstances as the former, and she too will not know when the wind is in the east. i. ventilation and warming. [sidenote: first rule of nursing, to keep the air within as pure as the air without.] the very first canon of nursing, the first and the last thing upon which a nurse's attention must be fixed, the first essential to the patient, without which all the rest you can do for him is as nothing, with which i had almost said you may leave all the rest alone, is this: to keep the air he breathes as pure as the external air, without chilling him. yet what is so little attended to? even where it is thought of at all, the most extraordinary misconceptions reign about it. even in admitting air into the patient's room or ward, few people ever think, where that air comes from. it may come from a corridor into which other wards are ventilated, from a hall, always unaired, always full of the fumes of gas, dinner, of various kinds of mustiness; from an underground kitchen, sink, washhouse, water-closet, or even, as i myself have had sorrowful experience, from open sewers loaded with filth; and with this the patient's room or ward is aired, as it is called--poisoned, it should rather be said. always air from the air without, and that, too, through those windows, through which the air comes freshest. from a closed court, especially if the wind do not blow that way, air may come as stagnant as any from a hall or corridor. again, a thing i have often seen both in private houses and institutions. a room remains uninhabited; the fire place is carefully fastened up with a board; the windows are never opened; probably the shutters are kept always shut; perhaps some kind of stores are kept in the room; no breath of fresh air can by possibility enter into that room, nor any ray of sun. the air is as stagnant, musty, and corrupt as it can by possibility be made. it is quite ripe to breed small-pox, scarlet fever, diphtheria, or anything else you please.[ ] yet the nursery, ward, or sick room adjoining will positively be aired (?) by having the door opened into that room. or children will be put into that room, without previous preparation, to sleep. a short time ago a man walked into a back-kitchen in queen square, and cut the throat of a poor consumptive creature, sitting by the fire. the murderer did not deny the act, but simply said, "it's all right." of course he was mad. but in our case, the extraordinary thing is that the victim says, "it's all right," and that we are not mad. yet, although we "nose" the murderers, in the musty unaired unsunned room, the scarlet fever which is behind the door, or the fever and hospital gangrene which are stalking among the crowded beds of a hospital ward, we say, "it's all right." [sidenote: without chill.] with a proper supply of windows, and a proper supply of fuel in open fire places, fresh air is comparatively easy to secure when your patient or patients are in bed. never be afraid of open windows then. people don't catch cold in bed. this is a popular fallacy. with proper bed-clothes and hot bottles, if necessary, you can always keep a patient warm in bed, and well ventilate him at the same time. but a careless nurse, be her rank and education what it may, will stop up every cranny and keep a hot-house heat when her patient is in bed,--and, if he is able to get up, leave him comparatively unprotected. the time when people take cold (and there are many ways of taking cold, besides a cold in the nose,) is when they first get up after the two-fold exhaustion of dressing and of having had the skin relaxed by many hours, perhaps days, in bed, and thereby rendered more incapable of re-action. then the same temperature which refreshes the patient in bed may destroy the patient just risen. and common sense will point out that, while purity of air is essential, a temperature must be secured which shall not chill the patient. otherwise the best that can be expected will be a feverish re-action. to have the air within as pure as the air without, it is not necessary, as often appears to be thought, to make it as cold. in the afternoon again, without care, the patient whose vital powers have then risen often finds the room as close and oppressive as he found it cold in the morning. yet the nurse will be terrified, if a window is opened[ ]. [sidenote: open windows.] i know an intelligent humane house surgeon who makes a practice of keeping the ward windows open. the physicians and surgeons invariably close them while going their rounds; and the house surgeon very properly as invariably opens them whenever the doctors have turned their backs. in a little book on nursing, published a short time ago, we are told, that "with proper care it is very seldom that the windows cannot be opened for a few minutes twice in the day to admit fresh air from without." i should think not; nor twice in the hour either. it only shows how little the subject has been considered. [sidenote: what kind of warmth desirable.] of all methods of keeping patients warm the very worst certainly is to depend for heat on the breath and bodies of the sick. i have known a medical officer keep his ward windows hermetically closed, thus exposing the sick to all the dangers of an infected atmosphere, because he was afraid that, by admitting fresh air, the temperature of the ward would be too much lowered. this is a destructive fallacy. to attempt to keep a ward warm at the expense of making the sick repeatedly breathe their own hot, humid, putrescing atmosphere is a certain way to delay recovery or to destroy life. [sidenote: bedrooms almost universally foul.] do you ever go into the bed-rooms of any persons of any class, whether they contain one, two, or twenty people, whether they hold sick or well, at night, or before the windows are opened in the morning, and ever find the air anything but unwholesomely close and foul? and why should it be so? and of how much importance it is that it should not be so? during sleep, the human body, even when in health, is far more injured by the influence of foul air than when awake. why can't you keep the air all night, then, as pure as the air without in the rooms you sleep in? but for this, you must have sufficient outlet for the impure air you make yourselves to go out; sufficient inlet for the pure air from without to come in. you must have open chimneys, open windows, or ventilators; no close curtains round your beds; no shutters or curtains to your windows, none of the contrivances by which you undermine your own health or destroy the chances of recovery of your sick.[ ] [sidenote: when warmth must be most carefully looked to.] a careful nurse will keep a constant watch over her sick, especially weak, protracted, and collapsed cases, to guard against the effects of the loss of vital heat by the patient himself. in certain diseased states much less heat is produced than in health; and there is a constant tendency to the decline and ultimate extinction of the vital powers by the call made upon them to sustain the heat of the body. cases where this occurs should be watched with the greatest care from hour to hour, i had almost said from minute to minute. the feet and legs should be examined by the hand from time to time, and whenever a tendency to chilling is discovered, hot bottles, hot bricks, or warm flannels, with some warm drink, should be made use of until the temperature is restored. the fire should be, if necessary, replenished. patients are frequently lost in the latter stages of disease from want of attention to such simple precautions. the nurse may be trusting to the patient's diet, or to his medicine, or to the occasional dose of stimulant which she is directed to give him, while the patient is all the while sinking from want of a little external warmth. such cases happen at all times, even during the height of summer. this fatal chill is most apt to occur towards early morning at the period of the lowest temperature of the twenty-four hours, and at the time when the effect of the preceding day's diets is exhausted. generally speaking, you may expect that weak patients will suffer cold much more in the morning than in the evening. the vital powers are much lower. if they are feverish at night, with burning hands and feet, they are almost sure to be chilly and shivering in the morning. but nurses are very fond of heating the foot-warmer at night, and of neglecting it in the morning, when they are busy. i should reverse the matter. all these things require common sense and care. yet perhaps in no one single thing is so little common sense shewn, in all ranks, as in nursing.[ ] [sidenote: cold air not ventilation, nor fresh air a method of chill.] the extraordinary confusion between cold and ventilation, in the minds of even well educated people, illustrates this. to make a room cold is by no means necessarily to ventilate it. nor is it at all necessary, in order to ventilate a room, to chill it. yet, if a nurse finds a room close, she will let out the fire, thereby making it closer, or she will open the door into a cold room, without a fire, or an open window in it, by way of improving the ventilation. the safest atmosphere of all for a patient is a good fire and an open window, excepting in extremes of temperature. (yet no nurse can ever be made to understand this.) to ventilate a small room without draughts of course requires more care than to ventilate a large one. [sidenote: night air.] another extraordinary fallacy is the dread of night air. what air can we breathe at night but night air? the choice is between pure night air from without and foul night air from within. most people prefer the latter. an unaccountable choice. what will they say if it is proved to be true that fully one-half of all the disease we suffer from is occasioned by people sleeping with their windows shut? an open window most nights in the year can never hurt any one. this is not to say that light is not necessary for recovery. in great cities, night air is often the best and purest air to be had in the twenty-four hours. i could better understand in towns shutting the windows during the day than during the night, for the sake of the sick. the absence of smoke, the quiet, all tend to making night the best time for airing the patients. one of our highest medical authorities on consumption and climate has told me that the air in london is never so good as after ten o'clock at night. [sidenote: air from the outside. open your windows, shut your doors.] always air your room, then, from the outside air, if possible. windows are made to open; doors are made to shut--a truth which seems extremely difficult of apprehension. i have seen a careful nurse airing her patient's room through the door, near to which were two gaslights, (each of which consumes as much air as eleven men), a kitchen, a corridor, the composition of the atmosphere in which consisted of gas, paint, foul air, never changed, full of effluvia, including a current of sewer air from an ill-placed sink, ascending in a continual stream by a well-staircase, and discharging themselves constantly into the patient's room. the window of the said room, if opened, was all that was desirable to air it. every room must be aired from without--every passage from without. but the fewer passages there are in a hospital the better. [sidenote: smoke.] if we are to preserve the air within as pure as the air without, it is needless to say that the chimney must not smoke. almost all smoky chimneys can be cured--from the bottom, not from the top. often it is only necessary to have an inlet for air to supply the fire, which is feeding itself, for want of this, from its own chimney. on the other hand, almost all chimneys can be made to smoke by a careless nurse, who lets the fire get low and then overwhelms it with coal; not, as we verily believe, in order to spare herself trouble, (for very rare is unkindness to the sick), but from not thinking what she is about. [sidenote: airing damp things in a patient's room.] in laying down the principle that the first object of the nurse must be to keep the air breathed by her patient as pure as the air without, it must not be forgotten that everything in the room which can give off effluvia, besides the patient, evaporates itself into his air. and it follows that there ought to be nothing in the room, excepting him, which can give off effluvia or moisture. out of all damp towels, &c., which become dry in the room, the damp, of course, goes into the patient's air. yet this "of course" seems as little thought of, as if it were an obsolete fiction. how very seldom you see a nurse who acknowledges by her practice that nothing at all ought to be aired in the patient's room, that nothing at all ought to be cooked at the patient's fire! indeed the arrangements often make this rule impossible to observe. if the nurse be a very careful one, she will, when the patient leaves his bed, but not his room, open the sheets wide, and throw the bed clothes back, in order to air his bed. and she will spread the wet towels or flannels carefully out upon a horse, in order to dry them. now either these bed-clothes and towels are not dried and aired, or they dry and air themselves into the patient's air. and whether the damp and effluvia do him most harm in his air or in his bed, i leave to you to determine, for i cannot. [sidenote: effluvia from excreta.] even in health people cannot repeatedly breathe air in which they live with impunity, on account of its becoming charged with unwholesome matter from the lungs and skin. in disease where everything given off from the body is highly noxious and dangerous, not only must there be plenty of ventilation to carry off the effluvia, but everything which the patient passes must be instantly removed away, as being more noxious than even the emanations from the sick. of the fatal effects of the effluvia from the excreta it would seem unnecessary to speak, were they not so constantly neglected. concealing the utensils behind the vallance to the bed seems all the precaution which is thought necessary for safety in private nursing. did you but think for one moment of the atmosphere under that bed, the saturation of the under side of the mattress with the warm evaporations, you would be startled and frightened too! [sidenote: chamber utensils without lids.] the use of any chamber utensil _without a lid_[ ] should be utterly abolished, whether among sick or well. you can easily convince yourself of the necessity of this absolute rule, by taking one with a lid, and examining the under side of that lid. it will be found always covered, whenever the utensil is not empty, by condensed offensive moisture. where does that go, when there is no lid? earthenware, or if there is any wood, highly polished and varnished wood, are the only materials fit for patients' utensils. the very lid of the old abominable close-stool is enough to breed a pestilence. it becomes saturated with offensive matter, which scouring is only wanted to bring out. i prefer an earthenware lid as being always cleaner. but there are various good new-fashioned arrangements. [sidenote: abolish slop-pails.] a slop-pail should never be brought into a sick room. it should be a rule invariable, rather more important in the private house than elsewhere, that the utensil should be carried directly to the water-closet, emptied there, rinsed there, and brought back. there should always be water and a cock in every water-closet for rinsing. but even if there is not, you must carry water there to rinse with. i have actually seen, in the private sick room, the utensils emptied into the foot-pan, and put back unrinsed under the bed. i can hardly say which is most abominable, whether to do this or to rinse the utensil _in_ the sick room. in the best hospitals it is now a rule that no slop-pail shall ever be brought into the wards, but that the utensils shall be carried direct to be emptied and rinsed at the proper place. i would it were so in the private house. [sidenote: fumigations.] let no one ever depend upon fumigations, "disinfectants," and the like, for purifying the air. the offensive thing, not its smell, must be removed. a celebrated medical lecturer began one day "fumigations, gentlemen, are of essential importance. they make such an abominable smell that they compel you to open the window." i wish all the disinfecting fluids invented made such an "abominable smell" that they forced you to admit fresh air. that would be a useful invention. ii.--health of houses.[ ] [sidenote: health of houses. five points essential.] there are five essential points in securing the health of houses:-- . pure air. . pure water. . efficient drainage. . cleanliness. . light. without these, no house can be healthy. and it will be unhealthy just in proportion as they are deficient. [sidenote: pure air.] . to have pure air, your house must be so constructed as that the outer atmosphere shall find its way with ease to every corner of it. house architects hardly ever consider this. the object in building a house is to obtain the largest interest for the money, not to save doctors' bills to the tenants. but, if tenants should ever become so wise as to refuse to occupy unhealthily constructed houses, and if insurance companies should ever come to understand their interest so thoroughly as to pay a sanitary surveyor to look after the houses where their clients live, speculative architects would speedily be brought to their senses. as it is, they build what pays best. and there are always people foolish enough to take the houses they build. and if in the course of time the families die off, as is so often the case, nobody ever thinks of blaming any but providence[ ] for the result. ill-informed medical men aid in sustaining the delusion, by laying the blame on "current contagions." badly constructed houses do for the healthy what badly constructed hospitals do for the sick. once insure that the air in a house is stagnant, and sickness is certain to follow. [sidenote: pure water.] . pure water is more generally introduced into houses than it used to be, thanks to the exertions of the sanitary reformers. within the last few years, a large part of london was in the daily habit of using water polluted by the drainage of its sewers and water closets. this has happily been remedied. but, in many parts of the country, well water of a very impure kind is used for domestic purposes. and when epidemic disease shows itself, persons using such water are almost sure to suffer. [sidenote: drainage.] . it would be curious to ascertain by inspection, how many houses in london are really well drained. many people would say, surely all or most of them. but many people have no idea in what good drainage consists. they think that a sewer in the street, and a pipe leading to it from the house is good drainage. all the while the sewer may be nothing but a laboratory from which epidemic disease and ill health is being distilled into the house. no house with any untrapped drain pipe communicating immediately with a sewer, whether it be from water closet, sink, or gully-grate, can ever be healthy. an untrapped sink may at any time spread fever or pyæmia among the inmates of a palace. [sidenote: sinks.] the ordinary oblong sink is an abomination. that great surface of stone, which is always left wet, is always exhaling into the air. i have known whole houses and hospitals smell of the sink. i have met just as strong a stream of sewer air coming up the back staircase of a grand london house from the sink, as i have ever met at scutari; and i have seen the rooms in that house all ventilated by the open doors, and the passages all _un_ventilated by the closed windows, in order that as much of the sewer air as possible might be conducted into and retained in the bed-rooms. it is wonderful. another great evil in house construction is carrying drains underneath the house. such drains are never safe. all house drains should begin and end outside the walls. many people will readily admit, as a theory, the importance of these things. but how few are there who can intelligently trace disease in their households to such causes! is it not a fact, that when scarlet fever, measles, or small-pox appear among the children, the very first thought which occurs is, "where" the children can have "caught" the disease? and the parents immediately run over in their minds all the families with whom they may have been. they never think of looking at home for the source of the mischief. if a neighbour's child is seized with small-pox, the first question which occurs is whether it had been vaccinated. no one would undervalue vaccination; but it becomes of doubtful benefit to society when it leads people to look abroad for the source of evils which exist at home. [sidenote: cleanliness.] . without cleanliness, within and without your house, ventilation is comparatively useless. in certain foul districts of london, poor people used to object to open their windows and doors because of the foul smells that came in. rich people like to have their stables and dunghill near their houses. but does it ever occur to them that with many arrangements of this kind it would be safer to keep the windows shut than open? you cannot have the air of the house pure with dung heaps under the windows. these are common all over london. and yet people are surprised that their children, brought up in large "well-aired" nurseries and bed-rooms suffer from children's epidemics. if they studied nature's laws in the matter of children's health, they would not be so surprised. there are other ways of having filth inside a house besides having dirt in heaps. old papered walls of years' standing, dirty carpets, uncleansed furniture, are just as ready sources of impurity to the air as if there were a dung-heap in the basement. people are so unaccustomed from education and habits to consider how to make a home healthy, that they either never think of it at all, and take every disease as a matter of course, to be "resigned to" when it comes "as from the hand of providence;" or if they ever entertain the idea of preserving the health of their household as a duty, they are very apt to commit all kinds of "negligences and ignorances" in performing it. [sidenote: light.] . a dark house is always an unhealthy house, always an ill-aired house, always a dirty house. want of light stops growth, and promotes scrofula, rickets, &c., among the children. people lose their health in a dark house, and if they get ill they cannot get well again in it. more will be said about this farther on. [sidenote: three common errors in managing the health of houses.] three out of many "negligences and ignorances" in managing the health of houses generally, i will here mention as specimens-- . that the female head in charge of any building does not think it necessary to visit every hole and corner of it every day. how can she expect those who are under her to be more careful to maintain her house in a healthy condition than she who is in charge of it?-- . that it is not considered essential to air, to sun, and to clean rooms while uninhabited; which is simply ignoring the first elementary notion of sanitary things, and laying the ground ready for all kinds of diseases.-- . that the window, and one window, is considered enough to air a room. have you never observed that any room without a fire-place is always close? and, if you have a fire-place, would you cram it up not only with a chimney-board, but perhaps with a great wisp of brown paper, in the throat of the chimney--to prevent the soot from coming down, you say? if your chimney is foul, sweep it; but don't expect that you can ever air a room with only one aperture; don't suppose that to shut up a room is the way to keep it clean. it is the best way to foul the room and all that is in it. don't imagine that if you, who are in charge, don't look to all these things yourself, those under you will be more careful than you are. it appears as if the part of a mistress now is to complain of her servants, and to accept their excuses--not to show them how there need be neither complaints made nor excuses. [sidenote: head in charge must see to house hygiene, not do it herself.] but again, to look to all these things yourself does not mean to do them yourself. "i always open the windows," the head in charge often says. if you do it, it is by so much the better, certainly, than if it were not done at all. but can you not insure that it is done when not done by yourself? can you insure that it is not undone when your back is turned? this is what being "in charge" means. and a very important meaning it is, too. the former only implies that just what you can do with your own hands is done. the latter that what ought to be done is always done. [sidenote: does god think of these things so seriously?] and now, you think these things trifles, or at least exaggerated. but what you "think" or what i "think" matters little. let us see what god thinks of them. god always justifies his ways. while we are thinking, he has been teaching. i have known cases of hospital pyæmia quite as severe in handsome private houses as in any of the worst hospitals, and from the same cause, viz., foul air. yet nobody learnt the lesson. nobody learnt _anything_ at all from it. they went on _thinking_--thinking that the sufferer had scratched his thumb, or that it was singular that "all the servants" had "whitlows," or that something was "much about this year; there is always sickness in our house." this is a favourite mode of thought--leading _not_ to inquire what is the uniform cause of these general "whitlows," but to stifle all inquiry. in what sense is "sickness" being "always there," a justification of its being "there" at all? [sidenote: how does he carry out his laws?] [sidenote: how does he teach his laws?] i will tell you what was the cause of this hospital pyæmia being in that large private house. it was that the sewer air from an ill-placed sink was carefully conducted into all the rooms by sedulously opening all the doors, and closing all the passage windows. it was that the slops were emptied into the foot pans;--it was that the utensils were never properly rinsed;--it was that the chamber crockery was rinsed with dirty water;--it was that the beds were never properly shaken, aired, picked to pieces, or changed. it was that the carpets and curtains were always musty;--it was that the furniture was always dusty; it was that the papered walls were saturated with dirt;--it was that the floors were never cleaned;--it was that the uninhabited rooms were never sunned, or cleaned, or aired;--it was that the cupboards were always reservoirs of foul air;--it was that the windows were always tight shut up at night;--it was that no window was ever systematically opened, even in the day, or that the right window was not opened. a person gasping for air might open a window for himself. but the servants were not taught to open the windows, to shut the doors; or they opened the windows upon a dank well between high walls, not upon the airier court; or they opened the room doors into the unaired halls and passages, by way of airing the rooms. now all this is not fancy, but fact. in that handsome house i have known in one summer three cases of hospital pyæmia, one of phlebitis, two of consumptive cough: all the _immediate_ products of foul air. when, in temperate climates, a house is more unhealthy in summer than in winter, it is a certain sign of something wrong. yet nobody learns the lesson. yes, god always justifies his ways. he is teaching while you are not learning. this poor body loses his finger, that one loses his life. and all from the most easily preventible causes.[ ] [sidenote: physical degeneration in families. its causes.] the houses of the grandmothers and great grandmothers of this generation, at least the country houses, with front door and back door always standing open, winter and summer, and a thorough draught always blowing through--with all the scrubbing, and cleaning, and polishing, and scouring which used to go on, the grandmothers, and still more the great grandmothers, always out of doors and never with a bonnet on except to go to church, these things entirely account for the fact so often seen of a great grandmother, who was a tower of physical vigour descending into a grandmother perhaps a little less vigorous but still sound as a bell and healthy to the core, into a mother languid and confined to her carriage and house, and lastly into a daughter sickly and confined to her bed. for, remember, even with a general decrease of mortality you may often find a race thus degenerating and still oftener a family. you may see poor little feeble washed-out rags, children of a noble stock, suffering morally and physically, throughout their useless, degenerate lives, and yet people who are going to marry and to bring more such into the world, will consult nothing but their own convenience as to where they are to live, or how they are to live. [sidenote: don't make your sick-room into a ventilating shaft for the whole house.] with regard to the health of houses where there is a sick person, it often happens that the sick room is made a ventilating shaft for the rest of the house. for while the house is kept as close, unaired, and dirty as usual, the window of the sick room is kept a little open always, and the door occasionally. now, there are certain sacrifices which a house with one sick person in it does make to that sick person: it ties up its knocker; it lays straw before it in the street. why can't it keep itself thoroughly clean and unusually well aired, in deference to the sick person? [sidenote: infection.] we must not forget what, in ordinary language, is called "infection;"[ ]--a thing of which people are generally so afraid that they frequently follow the very practice in regard to it which they ought to avoid. nothing used to be considered so infectious or contagious as small pox; and people not very long ago used to cover up patients with heavy bed clothes, while they kept up large fires and shut the windows. small pox, of course, under this _régime_, is very "infectious." people are somewhat wiser now in their management of this disease. they have ventured to cover the patients lightly and to keep the windows open; and we hear much less of the "infection" of small pox than we used to do. but do people in our days act with more wisdom on the subject of "infection" in fevers--scarlet fever, measles, &c.--than their forefathers did with small pox? does not the popular idea of "infection" involve that people should take greater care of themselves than of the patient? that, for instance, it is safer not to be too much with the patient, not to attend too much to his wants? perhaps the best illustration of the utter absurdity of this view of duty in attending on "infectious" diseases is afforded by what was very recently the practice, if it is not so even now, in some of the european lazarets--in which the plague-patient used to be condemned to the horrors of filth, overcrowding, and want of ventilation, while the medical attendant was ordered to examine the patient's tongue through an opera-glass and to toss him a lancet to open his abscesses with! true nursing ignores infection, except to prevent it. cleanliness and fresh air from open windows, with unremitting attention to the patient, are the only defence a true nurse either asks or needs. wise and humane management of the patient is the best safeguard against infection. [sidenote: why must children have measles, &c.?] there are not a few popular opinions, in regard to which it is useful at times to ask a question or two. for example, it is commonly thought that children must have what are commonly called "children's epidemics," "current contagions," &c., in other words, that they are born to have measles, hooping-cough, perhaps even scarlet fever, just as they are born to cut their teeth, if they live. now, do tell us, why must a child have measles? oh because, you say, we cannot keep it from infection--other children have measles--and it must take them--and it is safer that it should. but why must other children have measles? and if they have, why must yours have them too? if you believed in and observed the laws for preserving the health of houses which inculcate cleanliness, ventilation, white-washing, and other means, and which, by the way, _are laws_, as implicitly as you believe in the popular opinion, for it is nothing more than an opinion, that your child must have children's epidemics, don't you think that upon the whole your child would be more likely to escape altogether? iii. petty management. [sidenote: petty management.] all the results of good nursing, as detailed in these notes, may be spoiled or utterly negatived by one defect, viz.: in petty management, or, in other words, by not knowing how to manage that what you do when you are there, shall be done when you are not there. the most devoted friend or nurse cannot be always _there_. nor is it desirable that she should. and she may give up her health, all her other duties, and yet, for want of a little management, be not one-half so efficient as another who is not one-half so devoted, but who has this art of multiplying herself--that is to say, the patient of the first will not really be so well cared for, as the patient of the second. it is as impossible in a book to teach a person in charge of sick how to _manage_, as it is to teach her how to nurse. circumstances must vary with each different case. but it _is_ possible to press upon her to think for herself: now what does happen during my absence? i am obliged to be away on tuesday. but fresh air, or punctuality is not less important to my patient on tuesday than it was on monday. or: at p.m. i am never with my patient; but quiet is of no less consequence to him at than it was at minutes to . curious as it may seem, this very obvious consideration occurs comparatively to few, or, if it does occur, it is only to cause the devoted friend or nurse to be absent fewer hours or fewer minutes from her patient--not to arrange so as that no minute and no hour shall be for her patient without the essentials of her nursing. [sidenote: illustrations of the want of it.] a very few instances will be sufficient, not as precepts, but as illustrations. [sidenote: strangers coming into the sick room.] a strange washerwoman, coming late at night for the "things," will burst in by mistake to the patient's sick-room, after he has fallen into his first doze, giving him a shock, the effects of which are irremediable, though he himself laughs at the cause, and probably never even mentions it. the nurse who is, and is quite right to be, at her supper, has not provided that the washerwoman shall not lose her way and go into the wrong room. [sidenote: sick room airing the whole house.] the patient's room may always have the window open. but the passage outside the patient's room, though provided with several large windows, may never have one open. because it is not understood that the charge of the sick-room extends to the charge of the passage. and thus, as often happens, the nurse makes it her business to turn the patient's room into a ventilating shaft for the foul air of the whole house. [sidenote: uninhabited room fouling the whole house.] an uninhabited room, a newly painted room,[ ] an uncleaned closet or cupboard, may often become a reservoir of foul air for the whole house, because the person in charge never thinks of arranging that these places shall be always aired, always cleaned; she merely opens the window herself "when she goes in." [sidenote: delivery and non-delivery of letters and messages.] an agitating letter or message may be delivered, or an important letter or message _not_ delivered; a visitor whom it was of consequence to see, may be refused, or one whom it was of still more consequence _not_ to see may be admitted--because the person in charge has never asked herself this question, what is done when i am not there?[ ] at all events, one may safely say, a nurse cannot be with the patient, open the door, eat her meals, take a message, all at one and the same time. nevertheless the person in charge never seems to look the impossibility in the face. add to this that the _attempting_ this impossibility does more to increase the poor patient's hurry and nervousness than anything else. [sidenote: partial measures such as "being always in the way" yourself, increase instead of saving the patient's anxiety. because they must be only partial.] it is never thought that the patient remembers these things if you do not. he has not only to think whether the visit or letter may arrive, but whether you will be in the way at the particular day and hour when it may arrive. so that your _partial_ measures for "being in the way" yourself, only increase the necessity for his thought. whereas, if you could but arrange that the thing should always be done whether you are there or not, he need never think at all about it. for the above reasons, whatever a patient _can_ do for himself, it is better, i.e. less anxiety, for him to do for himself, unless the person in charge has the spirit of management. it is evidently much less exertion for a patient to answer a letter for himself by return of post, than to have four conversations, wait five days, have six anxieties before it is off his mind, before the person who is to answer it has done so. apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion. remember, he is face to face with his enemy all the time, internally wrestling with him, having long imaginary conversations with him. you are thinking of something else. "rid him of his adversary quickly," is a first rule with the sick.[ ] for the same reasons, always tell a patient and tell him beforehand when you are going out and when you will be back, whether it is for a day, an hour, or ten minutes. you fancy perhaps that it is better for him if he does not find out your going at all, better for him if you do not make yourself "of too much importance" to him; or else you cannot bear to give him the pain or the anxiety of the temporary separation. no such thing. you _ought_ to go, we will suppose. health or duty requires it. then say so to the patient openly. if you go without his knowing it, and he finds it out, he never will feel secure again that the things which depend upon you will be done when you are away, and in nine cases out of ten he will be right. if you go out without telling him when you will be back, he can take no measures nor precautions as to the things which concern you both, or which you do for him. [sidenote: what is the cause of half the accidents which happen?] if you look into the reports of trials or accidents, and especially of suicides, or into the medical history of fatal cases, it is almost incredible how often the whole thing turns upon something which has happened because "he," or still oftener "she," "was not there." but it is still more incredible how often, how almost always this is accepted as a sufficient reason, a justification; why, the very fact of the thing having happened is the proof of its not being a justification. the person in charge was quite right not to be "_there_," he was called away for quite sufficient reason, or he was away for a daily recurring and unavoidable cause: yet no provision was made to supply his absence. the fault was not in his "being away," but in there being no management to supplement his "being away." when the sun is under a total eclipse or during his nightly absence, we light candles. but it would seem as if it did not occur to us that we must also supplement the person in charge of sick or of children, whether under an occasional eclipse or during a regular absence. in institutions where many lives would be lost and the effect of such want of management would be terrible and patent, there is less of it than in the private house.[ ] but in both, let whoever is in charge keep this simple question in her head (_not_, how can i always do this right thing myself, but) how can i provide for this right thing to be always done? then, when anything wrong has actually happened in consequence of her absence, which absence we will suppose to have been quite right, let her question still be (_not_, how can i provide against any more of such absences? which is neither possible nor desirable, but) how can i provide against any thing wrong arising out of my absence? [sidenote: what it is to be "in charge."] how few men, or even women, understand, either in great or in little things, what it is the being "in charge"--i mean, know how to carry out a "charge." from the most colossal calamities, down to the most trifling accidents, results are often traced (or rather _not_ traced) to such want of some one "in charge" or of his knowing how to be "in charge." a short time ago the bursting of a funnel-casing on board the finest and strongest ship that ever was built, on her trial trip, destroyed several lives and put several hundreds in jeopardy--not from any undetected flaw in her new and untried works--but from a tap being closed which ought not to have been closed--from what every child knows would make its mother's tea-kettle burst. and this simply because no one seemed to know what it is to be "in charge," or _who_ was in charge. nay more, the jury at the inquest actually altogether ignored the same, and apparently considered the tap "in charge," for they gave as a verdict "accidental death." this is the meaning of the word, on a large scale. on a much smaller scale, it happened, a short time ago, that an insane person burnt herself slowly and intentionally to death, while in her doctor's charge and almost in her nurse's presence. yet neither was considered "at all to blame." the very fact of the accident happening proves its own case. there is nothing more to be said. either they did not know their business or they did not know how to perform it. to be "in charge" is certainly not only to carry out the proper measures yourself but to see that every one else does so too; to see that no one either wilfully or ignorantly thwarts or prevents such measures. it is neither to do everything yourself nor to appoint a number of people to each duty, but to ensure that each does that duty to which he is appointed. this is the meaning which must be attached to the word by (above all) those "in charge" of sick, whether of numbers or of individuals, (and indeed i think it is with individual sick that it is least understood. one sick person is often waited on by four with less precision, and is really less cared for than ten who are waited on by one; or at least than who are waited on by ; and all for want of this one person "in charge.)" it is often said that there are few good servants now: i say there are few good mistresses now. as the jury seems to have thought the tap was in charge of the ship's safety, so mistresses now seem to think the house is in charge of itself. they neither know how to give orders, nor how to teach their servants to obey orders--i.e. to obey intelligently, which is the real meaning of all discipline. again, people who are in charge often seem to have a pride in feeling that they will be "missed," that no one can understand or carry on their arrangements, their system, books, accounts, &c., but themselves. it seems to me that the pride is rather in carrying on a system, in keeping stores, closets, books, accounts, &c., so that any body can understand and carry them on--so that, in case of absence or illness, one can deliver every thing up to others and know that all will go on as usual, and that one shall never be missed. [sidenote: why hired nurses give so much trouble.] note.--it is often complained, that professional nurses, brought into private families, in case of sickness, make themselves intolerable by "ordering about" the other servants, under plea of not neglecting the patient. both things are true; the patient is often neglected, and the servants are often unfairly "put upon." but the fault is generally in the want of management of the head in charge. it is surely for her to arrange both that the nurse's place is, when necessary, supplemented, and that the patient is never neglected--things with a little management quite compatible, and indeed only attainable together. it is certainly not for the nurse to "order about" the servants. iv. noise. [sidenote: unnecessary noise.] unnecessary noise, or noise that creates an expectation in the mind, is that which hurts a patient. it is rarely the loudness of the noise, the effect upon the organ of the ear itself, which appears to affect the sick. how well a patient will generally bear, e.g., the putting up of a scaffolding close to the house, when he cannot bear the talking, still less the whispering, especially if it be of a familiar voice, outside his door. there are certain patients, no doubt, especially where there is slight concussion or other disturbance of the brain, who are affected by mere noise. but intermittent noise, or sudden and sharp noise, in these as in all other cases, affects far more than continuous noise--noise with jar far more than noise without. of one thing you may be certain, that anything which wakes a patient suddenly out of his sleep will invariably put him into a state of greater excitement, do him more serious, aye, and lasting mischief, than any continuous noise, however loud. [sidenote: never let a patient be waked out of his first sleep.] never to allow a patient to be waked, intentionally or accidentally, is a _sine quâ non_ of all good nursing. if he is roused out of his first sleep, he is almost certain to have no more sleep. it is a curious but quite intelligible fact that, if a patient is waked after a few hours' instead of a few minutes' sleep, he is much more likely to sleep again. because pain, like irritability of brain, perpetuates and intensifies itself. if you have gained a respite of either in sleep you have gained more than the mere respite. both the probability of recurrence and of the same intensity will be diminished; whereas both will be terribly increased by want of sleep. this is the reason why sleep is so all-important. this is the reason why a patient waked in the early part of his sleep loses not only his sleep, but his power to sleep. a healthy person who allows himself to sleep during the day will lose his sleep at night. but it is exactly the reverse with the sick generally; the more they sleep, the better will they be able to sleep. [sidenote: noise which excites expectation.] [sidenote: whispered conversation in the room.] i have often been surprised at the thoughtlessness, (resulting in cruelty, quite unintentionally) of friends or of doctors who will hold a long conversation just in the room or passage adjoining to the room of the patient, who is either every moment expecting them to come in, or who has just seen them, and knows they are talking about him. if he is an amiable patient, he will try to occupy his attention elsewhere and not to listen--and this makes matters worse--for the strain upon his attention and the effort he makes are so great that it is well if he is not worse for hours after. if it is a whispered conversation in the same room, then it is absolutely cruel; for it is impossible that the patient's attention should not be involuntarily strained to hear. walking on tip-toe, doing any thing in the room very slowly, are injurious, for exactly the same reasons. a firm light quick step, a steady quick hand are the desiderata; not the slow, lingering, shuffling foot, the timid, uncertain touch. slowness is not gentleness, though it is often mistaken for such; quickness, lightness, and gentleness are quite compatible. again, if friends and doctors did but watch, as nurses can and should watch, the features sharpening, the eyes growing almost wild, of fever patients who are listening for the entrance from the corridor of the persons whose voices they are hearing there, these would never run the risk again of creating such expectation, or irritation of mind.--such unnecessary noise has undoubtedly induced or aggravated delirium in many cases. i have known such--in one case death ensued. it is but fair to say that this death was attributed to fright. it was the result of a long whispered conversation, within sight of the patient, about an impending operation; but any one who has known the more than stoicism, the cheerful coolness, with which the certainty of an operation will be accepted by any patient, capable of bearing an operation at all, if it is properly communicated to him, will hesitate to believe that it was mere fear which produced, as was averred, the fatal result in this instance. it was rather the uncertainty, the strained expectation as to what was to be decided upon. [sidenote: or just outside the door.] i need hardly say that the other common cause, namely, for a doctor or friend to leave the patient and communicate his opinion on the result of his visit to the friends just outside the patient's door, or in the adjoining room, after the visit, but within hearing or knowledge of the patient is, if possible, worst of all. [sidenote: noise of female dress.] it is, i think, alarming, peculiarly at this time, when the female ink-bottles are perpetually impressing upon us "woman's" "particular worth and general missionariness," to see that the dress of women is daily more and more unfitting them for any "mission," or usefulness at all. it is equally unfitted for all poetic and all domestic purposes. a man is now a more handy and far less objectionable being in a sick-room than a woman. compelled by her dress, every woman now either shuffles or waddles--only a man can cross the floor of a sick-room without shaking it! what is become of woman's light step?--the firm, light, quick step we have been asking for? unnecessary noise, then, is the most cruel absence of care which can be inflicted either on sick or well. for, in all these remarks, the sick are only mentioned as suffering in a greater proportion than the well from precisely the same causes. unnecessary (although slight) noise injures a sick person much more than necessary noise (of a much greater amount). [sidenote: patient's repulsion to nurses who rustle.] all doctrines about mysterious affinities and aversions will be found to resolve themselves very much, if not entirely, into presence or absence of care in these things. a nurse who rustles (i am speaking of nurses professional and unprofessional) is the horror of a patient, though perhaps he does not know why. the fidget of silk and of crinoline, the rattling of keys, the creaking of stays and of shoes, will do a patient more harm than all the medicines in the world will do him good. the noiseless step of woman, the noiseless drapery of woman, are mere figures of speech in this day. her skirts (and well if they do not throw down some piece of furniture) will at least brush against every article in the room as she moves.[ ] again, one nurse cannot open the door without making everything rattle. or she opens the door unnecessarily often, for want of remembering all the articles that might be brought in at once. a good nurse will always make sure that no door or window in her patient's room shall rattle or creak; that no blind or curtain shall, by any change of wind through the open window, be made to flap--especially will she be careful of all this before she leaves her patients for the night. if you wait till your patients tell you, or remind you of these things, where is the use of their having a nurse? there are more shy than exacting patients, in all classes; and many a patient passes a bad night, time after time, rather than remind his nurse every night of all the things she has forgotten. if there are blinds to your windows, always take care to have them well up, when they are not being used. a little piece slipping down, and flapping with every draught, will distract a patient. [sidenote: hurry peculiarly hurtful to sick.] all hurry or bustle is peculiarly painful to the sick. and when a patient has compulsory occupations to engage him, instead of having simply to amuse himself, it becomes doubly injurious. the friend who remains standing and fidgetting about while a patient is talking business to him, or the friend who sits and proses, the one from an idea of not letting the patient talk, the other from an idea of amusing him,--each is equally inconsiderate. always sit down when a sick person is talking business to you, show no signs of hurry, give complete attention and full consideration if your advice is wanted, and go away the moment the subject is ended. [sidenote: how to visit the sick and not hurt them.] always sit within the patient's view, so that when you speak to him he has not painfully to turn his head round in order to look at you. everybody involuntarily looks at the person speaking. if you make this act a wearisome one on the part of the patient you are doing him harm. so also if by continuing to stand you make him continuously raise his eyes to see you. be as motionless as possible, and never gesticulate in speaking to the sick. never make a patient repeat a message or request, especially if it be some time after. occupied patients are often accused of doing too much of their own business. they are instinctively right. how often you hear the person, charged with the request of giving the message or writing the letter, say half an hour afterwards to the patient, "did you appoint o'clock?" or, "what did you say was the address?" or ask perhaps some much more agitating question--thus causing the patient the effort of memory, or worse still, of decision, all over again. it is really less exertion to him to write his letters himself. this is the almost universal experience of occupied invalids. this brings us to another caution. never speak to an invalid from behind, nor from the door, nor from any distance from him, nor when he is doing anything. the official politeness of servants in these things is so grateful to invalids, that many prefer, without knowing why, having none but servants about them. [sidenote: these things not fancy.] these things are not fancy. if we consider that, with sick as with well, every thought decomposes some nervous matter,--that decomposition as well as re-composition of nervous matter is always going on, and more quickly with the sick than with the well,--that, to obtrude abruptly another thought upon the brain while it is in the act of destroying nervous matter by thinking, is calling upon it to make a new exertion,--if we consider these things, which are facts, not fancies, we shall remember that we are doing positive injury by interrupting, by "startling a fanciful" person, as it is called. alas! it is no fancy. [sidenote: interruption damaging to sick.] if the invalid is forced, by his avocations, to continue occupations requiring much thinking, the injury is doubly great. in feeding a patient suffering under delirium or stupor you may suffocate him, by giving him his food suddenly, but if you rub his lips gently with a spoon and thus attract his attention, he will swallow the food unconsciously, but with perfect safety. thus it is with the brain. if you offer it a thought, especially one requiring a decision, abruptly, you do it a real not fanciful injury. never speak to a sick person suddenly; but, at the same time, do not keep his expectation on the tiptoe. [sidenote: and to well.] this rule, indeed, applies to the well quite as much as to the sick. i have never known persons who exposed themselves for years to constant interruption who did not muddle away their intellects by it at last. the process with them may be accomplished without pain. with the sick, pain gives warning of the injury. [sidenote: keeping a patient standing.] do not meet or overtake a patient who is moving about in order to speak to him, or to give him any message or letter. you might just as well give him a box on the ear. i have seen a patient fall flat on the ground who was standing when his nurse came into the room. this was an accident which might have happened to the most careful nurse. but the other is done with intention. a patient in such a state is not going to the east indies. if you would wait ten seconds, or walk ten yards further, any promenade he could make would be over. you do not know the effort it is to a patient to remain standing for even a quarter of a minute to listen to you. if i had not seen the thing done by the kindest nurses and friends, i should have thought this caution quite superfluous.[ ] [sidenote: patients dread surprise.] patients are often accused of being able to "do much more when nobody is by." it is quite true that they can. unless nurses can be brought to attend to considerations of the kind of which we have given here but a few specimens, a very weak patient finds it really much less exertion to do things for himself than to ask for them. and he will, in order to do them, (very innocently and from instinct) calculate the time his nurse is likely to be absent, from a fear of her "coming in upon" him or speaking to him, just at the moment when he finds it quite as much as he can do to crawl from his bed to his chair, or from one room to another, or down stairs, or out of doors for a few minutes. some extra call made upon his attention at that moment will quite upset him. in these cases you may be sure that a patient in the state we have described does not make such exertions more than once or twice a-day, and probably much about the same hour every day. and it is hard, indeed, if nurse and friends cannot calculate so as to let him make them undisturbed. remember, that many patients can walk who cannot stand or even sit up. standing is, of all positions, the most trying to a weak patient. everything you do in a patient's room, after he is "put up" for the night, increases tenfold the risk of his having a bad night. but, if you rouse him up after he has fallen asleep, you do not risk, you secure him a bad night. one hint i would give to all who attend or visit the sick, to all who have to pronounce an opinion upon sickness or its progress. come back and look at your patient _after_ he has had an hour's animated conversation with you. it is the best test of his real state we know. but never pronounce upon him from merely seeing what he does, or how he looks, during such a conversation. learn also carefully and exactly, if you can, how he passed the night after it. [sidenote: effects of over-exertion on sick.] people rarely, if ever, faint while making an exertion. it is after it is over. indeed, almost every effect of over-exertion appears after, not during such exertion. it is the highest folly to judge of the sick, as is so often done, when you see them merely during a period of excitement. people have very often died of that which, it has been proclaimed at the time, has "done them no harm."[ ] remember never to lean against, sit upon, or unnecessarily shake, or even touch the bed in which a patient lies. this is invariably a painful annoyance. if you shake the chair on which he sits, he has a point by which to steady himself, in his feet. but on a bed or sofa, he is entirely at your mercy, and he feels every jar you give him all through him. [sidenote: difference between real and fancy patients.] in all that we have said, both here and elsewhere, let it be distinctly understood that we are not speaking of hypochondriacs. to distinguish between real and fancied disease forms an important branch of the education of a nurse. to manage fancy patients forms an important branch of her duties. but the nursing which real and that which fancied patients require is of different, or rather of opposite, character. and the latter will not be spoken of here. indeed, many of the symptoms which are here mentioned are those which distinguish real from fancied disease. it is true that hypochondriacs very often do that behind a nurse's back which they would not do before her face. many such i have had as patients who scarcely ate anything at their regular meals; but if you concealed food for them in a drawer, they would take it at night or in secret. but this is from quite a different motive. they do it from the wish to conceal. whereas the real patient will often boast to his nurse or doctor, if these do not shake their heads at him, of how much he has done, or eaten, or walked. to return to real disease. [sidenote: conciseness necessary with sick.] conciseness and decision are, above all things, necessary with the sick. let your thought expressed to them be concisely and decidedly expressed. what doubt and hesitation there may be in your own mind must never be communicated to theirs, not even (i would rather say especially not) in little things. let your doubt be to yourself, your decision to them. people who think outside their heads, the whole process of whose thought appears, like homer's, in the act of secretion, who tell everything that led them towards this conclusion and away from that, ought never to be with the sick. [sidenote: irresolution most painful to them.] irresolution is what all patients most dread. rather than meet this in others, they will collect all their data, and make up their minds for themselves. a change of mind in others, whether it is regarding an operation, or re-writing a letter, always injures the patient more than the being called upon to make up his mind to the most dreaded or difficult decision. farther than this, in very many cases, the imagination in disease is far more active and vivid than it is in health. if you propose to the patient change of air to one place one hour, and to another the next, he has, in each case, immediately constituted himself in imagination the tenant of the place, gone over the whole premises in idea, and you have tired him as much by displacing his imagination, as if you had actually carried him over both places. above all leave the sick room quickly and come into it quickly, not suddenly, not with a rush. but don't let the patient be wearily waiting for when you will be out of the room or when you will be in it. conciseness and decision in your movements, as well as your words, are necessary in the sick room, as necessary as absence of hurry and bustle. to possess yourself entirely will ensure you from either failing--either loitering or hurrying. [sidenote: what a patient must not have to see to.] if a patient has to see, not only to his own but also to his nurse's punctuality, or perseverance, or readiness, or calmness, to any or all of these things, he is far better without that nurse than with her--however valuable and handy her services may otherwise be to him, and however incapable he may be of rendering them to himself. [sidenote: reading aloud.] with regard to reading aloud in the sick room, my experience is, that when the sick are too ill to read to themselves, they can seldom bear to be read to. children, eye-patients, and uneducated persons are exceptions, or where there is any mechanical difficulty in reading. people who like to be read to, have generally not much the matter with them; while in fevers, or where there is much irritability of brain, the effort of listening to reading aloud has often brought on delirium. i speak with great diffidence; because there is an almost universal impression that it is _sparing_ the sick to read aloud to them. but two things are certain:-- [sidenote: read aloud slowly, distinctly, and steadily to the sick.] ( .) if there is some matter which _must_ be read to a sick person, do it slowly. people often think that the way to get it over with least fatigue to him is to get it over in least time. they gabble; they plunge and gallop through the reading. there never was a greater mistake. houdin, the conjuror, says that the way to make a story seem short is to tell it slowly. so it is with reading to the sick. i have often heard a patient say to such a mistaken reader, "don't read it to me; tell it me."[ ] unconsciously he is aware that this will regulate the plunging, the reading with unequal paces, slurring over one part, instead of leaving it out altogether, if it is unimportant, and mumbling another. if the reader lets his own attention wander, and then stops to read up to himself, or finds he has read the wrong bit, then it is all over with the poor patient's chance of not suffering. very few people know how to read to the sick; very few read aloud as pleasantly even as they speak. in reading they sing, they hesitate, they stammer, they hurry, they mumble; when in speaking they do none of these things. reading aloud to the sick ought always to be rather slow, and exceedingly distinct, but not mouthing--rather monotonous, but not sing song--rather loud, but not noisy--and, above all, not too long. be very sure of what your patient can bear. [sidenote: never read aloud by fits and starts to the sick.] ( .) the extraordinary habit of reading to oneself in a sick room, and reading aloud to the patient any bits which will amuse him or more often the reader, is unaccountably thoughtless. what _do_ you think the patient is thinking of during your gaps of non-reading? do you think that he amuses himself upon what you have read for precisely the time it pleases you to go on reading to yourself, and that his attention is ready for something else at precisely the time it pleases you to begin reading again? whether the person thus read to be sick or well, whether he be doing nothing or doing something else while being thus read to, the self-absorption and want of observation of the person who does it, is equally difficult to understand--although very often the read_ee_ is too amiable to say how much it disturbs him. [sidenote: people overhead.] one thing more:--from the flimsy manner in which most modern houses are built, where every step on the stairs, and along the floors, is felt all over the house; the higher the story, the greater the vibration. it is inconceivable how much the sick suffer by having anybody overhead. in the solidly built old houses, which, fortunately, most hospitals are, the noise and shaking is comparatively trifling. but it is a serious cause of suffering, in lightly built houses, and with the irritability peculiar to some diseases. better far put such patients at the top of the house, even with the additional fatigue of stairs, if you cannot secure the room above them being untenanted; you may otherwise bring on a state of restlessness which no opium will subdue. do not neglect the warning, when a patient tells you that he "feels every step above him to cross his heart." remember that every noise a patient cannot _see_ partakes of the character of suddenness to him; and i am persuaded that patients with these peculiarly irritable nerves, are positively less injured by having persons in the same room with them than overhead, or separated by only a thin compartment. any sacrifice to secure silence for these cases is worth while, because no air, however good, no attendance, however careful, will do anything for such cases without quiet. [sidenote: music.] note.--the effect of music upon the sick has been scarcely at all noticed. in fact, its expensiveness, as it is now, makes any general application of it quite out of the question. i will only remark here, that wind instruments, including the human voice, and stringed instruments, capable of continuous sound, have generally a beneficent effect--while the piano-forte, with such instruments as have _no_ continuity of sound, has just the reverse. the finest piano-forte playing will damage the sick, while an air, like "home, sweet home," or "assisa a piè d'un salice," on the most ordinary grinding organ will sensibly soothe them--and this quite independent of association. v. variety. [sidenote: variety a means of recovery.] to any but an old nurse, or an old patient, the degree would be quite inconceivable to which the nerves of the sick suffer from seeing the same walls, the same ceiling, the same surroundings during a long confinement to one or two rooms. the superior cheerfulness of persons suffering severe paroxysms of pain over that of persons suffering from nervous debility has often been remarked upon, and attributed to the enjoyment of the former of their intervals of respite. i incline to think that the majority of cheerful cases is to be found among those patients who are not confined to one room, whatever their suffering, and that the majority of depressed cases will be seen among those subjected to a long monotony of objects about them. the nervous frame really suffers as much from this as the digestive organs from long monotony of diet, as e.g. the soldier from his twenty-one years' "boiled beef." [sidenote: colour and form means of recovery.] the effect in sickness of beautiful objects, of variety of objects, and especially of brilliancy of colour is hardly at all appreciated. such cravings are usually called the "fancies" of patients. and often doubtless patients have "fancies," as, e.g. when they desire two contradictions. but much more often, their (so called) "fancies" are the most valuable indications of what is necessary for their recovery. and it would be well if nurses would watch these (so called) "fancies" closely. i have seen, in fevers (and felt, when i was a fever patient myself) the most acute suffering produced from the patient (in a hut) not being able to see out of window, and the knots in the wood being the only view. i shall never forget the rapture of fever patients over a bunch of bright-coloured flowers. i remember (in my own case) a nosegay of wild flowers being sent me, and from that moment recovery becoming more rapid. [sidenote: this is no fancy.] people say the effect is only on the mind. it is no such thing. the effect is on the body, too. little as we know about the way in which we are affected by form, by colour, and light, we do know this, that they have an actual physical effect. variety of form and brilliancy of colour in the objects presented to patients are actual means of recovery. but it must be _slow_ variety, e.g., if you shew a patient ten or twelve engravings successively, ten-to-one that he does not become cold and faint, or feverish, or even sick; but hang one up opposite him, one on each successive day, or week, or month, and he will revel in the variety. [sidenote: flowers.] the folly and ignorance which reign too often supreme over the sick-room, cannot be better exemplified than by this. while the nurse will leave the patient stewing in a corrupting atmosphere, the best ingredient of which is carbonic acid; she will deny him, on the plea of unhealthiness, a glass of cut-flowers, or a growing plant. now, no one ever saw "overcrowding" by plants in a room or ward. and the carbonic acid they give off at nights would not poison a fly. nay, in overcrowded rooms, they actually absorb carbonic acid and give off oxygen. cut-flowers also decompose water and produce oxygen gas. it is true there are certain flowers, e.g., lilies, the smell of which is said to depress the nervous system. these are easily known by the smell, and can be avoided. [sidenote: effect of body on mind.] volumes are now written and spoken upon the effect of the mind upon the body. much of it is true. but i wish a little more was thought of the effect of the body on the mind. you who believe yourselves overwhelmed with anxieties, but are able every day to walk up regent-street, or out in the country, to take your meals with others in other rooms, &c., &c., you little know how much your anxieties are thereby lightened; you little know how intensified they become to those who can have no change;[ ] how the very walls of their sick rooms seem hung with their cares; how the ghosts of their troubles haunt their beds; how impossible it is for them to escape from a pursuing thought without some help from variety. a patient can just as much move his leg when it is fractured as change his thoughts when no external help from variety is given him. this is, indeed, one of the main sufferings of sickness; just as the fixed posture is one of the main sufferings of the broken limb. [sidenote: help the sick to vary their thoughts.] it is an ever recurring wonder to see educated people, who call themselves nurses, acting thus. they vary their own objects, their own employments many times a day; and while nursing (!) some bed-ridden sufferer, they let him lie there staring at a dead wall, without any change of object to enable him to vary his thoughts; and it never even occurs to them, at least to move his bed so that he can look out of window. no, the bed is to be always left in the darkest, dullest, remotest, part of the room.[ ] i think it is a very common error among the well to think that "with a little more self-control" the sick might, if they choose, "dismiss painful thoughts" which "aggravate their disease," &c. believe me, almost _any_ sick person, who behaves decently well, exercises more self-control every moment of his day than you will ever know till you are sick yourself. almost every step that crosses his room is painful to him; almost every thought that crosses his brain is painful to him; and if he can speak without being savage, and look without being unpleasant, he is exercising self-control. suppose you have been up all night, and instead of being allowed to have your cup of tea, you were to be told that you ought to "exercise self-control," what should you say? now, the nerves of the sick are always in the state that yours are in after you have been up all night. [sidenote: supply to the sick the defect of manual labour.] we will suppose the diet of the sick to be cared for. then, this state of nerves is most frequently to be relieved by care in affording them a pleasant view, a judicious variety as to flowers,[ ] and pretty things. light by itself will often relieve it. the craving for "the return of day," which the sick so constantly evince, is generally nothing but the desire for light, the remembrance of the relief which a variety of objects before the eye affords to the harassed sick mind. again, every man and every woman has some amount of manual employment, excepting a few fine ladies, who do not even dress themselves, and who are virtually in the same category, as to nerves, as the sick. now, you can have no idea of the relief which manual labour is to you--of the degree to which the deprivation of manual employment increases the peculiar irritability from which many sick suffer. a little needle-work, a little writing, a little cleaning, would be the greatest relief the sick could have, if they could do it; these _are_ the greatest relief to you, though you do not know it. reading, though it is often the only thing the sick can do, is not this relief. bearing this in mind, bearing in mind that you have all these varieties of employment which the sick cannot have, bear also in mind to obtain for them all the varieties which they can enjoy. i need hardly say that i am well aware that excess in needle-work, in writing, in any other continuous employment, will produce the same irritability that defect in manual employment (as one cause) produces in the sick. vi. taking food. [sidenote: want of attention to hours of taking food.] every careful observer of the sick will agree in this that thousands of patients are annually starved in the midst of plenty, from want of attention to the ways which alone make it possible for them to take food. this want of attention is as remarkable in those who urge upon the sick to do what is quite impossible to them, as in the sick themselves who will not make the effort to do what is perfectly possible to them. for instance, to the large majority of very weak patients it is quite impossible to take any solid food before a.m., nor then, if their strength is still further exhausted by fasting till that hour. for weak patients have generally feverish nights and, in the morning, dry mouths; and, if they could eat with those dry mouths, it would be the worse for them. a spoonful of beef-tea, of arrowroot and wine, of egg flip, every hour, will give them the requisite nourishment, and prevent them from being too much exhausted to take at a later hour the solid food, which is necessary for their recovery. and every patient who can swallow at all can swallow these liquid things, if he chooses. but how often do we hear a mutton-chop, an egg, a bit of bacon, ordered to a patient for breakfast, to whom (as a moment's consideration would show us) it must be quite impossible to masticate such things at that hour. again, a nurse is ordered to give a patient a tea-cup full of some article of food every three hours. the patient's stomach rejects it. if so, try a table-spoon full every hour; if this will not do, a tea-spoon full every quarter of an hour. i am bound to say, that i think more patients are lost by want of care and ingenuity in these momentous minutiæ in private nursing than in public hospitals. and i think there is more of the _entente cordiale_ to assist one another's hands between the doctor and his head nurse in the latter institutions, than between the doctor and the patient's friends in the private house. [sidenote: life often hangs upon minutes in taking food.] if we did but know the consequences which may ensue, in very weak patients, from ten minutes' fasting or repletion, (i call it repletion when they are obliged to let too small an interval elapse between taking food and some other exertion, owing to the nurse's unpunctuality), we should be more careful never to let this occur. in very weak patients there is often a nervous difficulty of swallowing, which is so much increased by any other call upon their strength that, unless they have their food punctually at the minute, which minute again must be arranged so as to fall in with no other minute's occupation, they can take nothing till the next respite occurs--so that an unpunctuality or delay of ten minutes may very well turn out to be one of two or three hours. and why is it not as easy to be punctual to a minute? life often literally hangs upon these minutes. in acute cases, where life or death is to be determined in a few hours, these matters are very generally attended to, especially in hospitals; and the number of cases is large where the patient is, as it were, brought back to life by exceeding care on the part of the doctor or nurse, or both, in ordering and giving nourishment with minute selection and punctuality. [sidenote: patients often starved to death in chronic cases.] but, in chronic cases, lasting over months and years, where the fatal issue is often determined at last by mere protracted starvation, i had rather not enumerate the instances which i have known where a little ingenuity, and a great deal of perseverance, might, in all probability, have averted the result. the consulting the hours when the patient can take food, the observation of the times, often varying, when he is most faint, the altering seasons of taking food, in order to anticipate and prevent such times--all this, which requires observation, ingenuity, and perseverance (and these really constitute the good nurse), might save more lives than we wot of. [sidenote: food never to be left by the patient's side.] to leave the patient's untasted food by his side, from meal to meal, in hopes that he will eat it in the interval, is simply to prevent him from taking any food at all. i have known patients literally incapacitated from taking one article of food after another, by this piece of ignorance. let the food come at the right time, and be taken away, eaten or uneaten, at the right time; but never let a patient have "something always standing" by him, if you don't wish to disgust him of everything. on the other hand, i have known a patient's life saved (he was sinking for want of food) by the simple question, put to him by the doctor, "but is there no hour when you feel you could eat?" "oh, yes," he said, "i could always take something at -- o'clock and -- o'clock." the thing was tried and succeeded. patients very seldom, however, can tell this; it is for you to watch and find it out. [sidenote: patient had better not see more food than his own.] a patient should, if possible, not see or smell either the food of others, or a greater amount of food than he himself can consume at one time, or even hear food talked about or see it in the raw state. i know of no exception to the above rule. the breaking of it always induces a greater or less incapacity of taking food. in hospital wards it is of course impossible to observe all this; and in single wards, where a patient must be continuously and closely watched, it is frequently impossible to relieve the attendant, so that his or her own meals can be taken out of the ward. but it is not the less true that, in such cases, even where the patient is not himself aware of it, his possibility of taking food is limited by seeing the attendant eating meals under his observation. in some cases the sick are aware of it, and complain. a case where the patient was supposed to be insensible, but complained as soon as able to speak, is now present to my recollection. remember, however, that the extreme punctuality in well-ordered hospitals, the rule that nothing shall be done in the ward while the patients are having their meals, go far to counterbalance what unavoidable evil there is in having patients together. i have often seen the private nurse go on dusting or fidgeting about in a sick room all the while the patient is eating, or trying to eat. that the more alone an invalid can be when taking food, the better, is unquestionable; and, even if he must be fed, the nurse should not allow him to talk, or talk to him, especially about food, while eating. when a person is compelled, by the pressure of occupation, to continue his business while sick, it ought to be a rule without any exception whatever, that no one shall bring business to him or talk to him while he is taking food, nor go on talking to him on interesting subjects up to the last moment before his meals, nor make an engagement with him immediately after, so that there be any hurry of mind while taking them. upon the observance of these rules, especially the first, often depends the patient's capability of taking food at all, or, if he is amiable and forces himself to take food, of deriving any nourishment from it. [sidenote: you cannot be too careful as to quality in sick diet.] a nurse should never put before a patient milk that is sour, meat or soup that is turned, an egg that is bad, or vegetables underdone. yet often i have seen these things brought in to the sick in a state perfectly perceptible to every nose or eye except the nurse's. it is here that the clever nurse appears; she will not bring in the peccant article, but, not to disappoint the patient, she will whip up something else in a few minutes. remember that sick cookery should half do the work of your poor patient's weak digestion. but if you further impair it with your bad articles, i know not what is to become of him or of it. if the nurse is an intelligent being, and not a mere carrier of diets to and from the patient, let her exercise her intelligence in these things. how often we have known a patient eat nothing at all in the day, because one meal was left untasted (at that time he was incapable of eating), at another the milk was sour, the third was spoiled by some other accident. and it never occurred to the nurse to extemporize some expedient,--it never occurred to her that as he had had no solid food that day, he might eat a bit of toast (say) with his tea in the evening, or he might have some meal an hour earlier. a patient who cannot touch his dinner at two, will often accept it gladly, if brought to him at seven. but somehow nurses never "think of these things." one would imagine they did not consider themselves bound to exercise their judgment; they leave it to the patient. now i am quite sure that it is better for a patient rather to suffer these neglects than to try to teach his nurse to nurse him, if she does not know how. it ruffles him, and if he is ill he is in no condition to teach, especially upon himself. the above remarks apply much more to private nursing than to hospitals. [sidenote: nurse must have some rule of thought about her patients diet.] i would say to the nurse, have a rule of thought about your patient's diet; consider, remember how much he has had, and how much he ought to have to-day. generally, the only rule of the private patient's diet is what the nurse has to give. it is true she cannot give him what she has not got; but his stomach does not wait for her convenience, or even her necessity.[ ] if it is used to having its stimulus at one hour to-day, and to-morrow it does not have it, because she has failed in getting it, he will suffer. she must be always exercising her ingenuity to supply defects, and to remedy accidents which will happen among the best contrivers, but from which the patient does not suffer the less, because "they cannot be helped." [sidenote: keep your patient's cup dry underneath.] one very minute caution,--take care not to spill into your patient's saucer, in other words, take care that the outside bottom rim of his cup shall be quite dry and clean; if, every time he lifts his cup to his lips, he has to carry the saucer with it, or else to drop the liquid upon, and to soil his sheet, or his bed-gown, or pillow, or if he is sitting up, his dress, you have no idea what a difference this minute want of care on your part makes to his comfort and even to his willingness for food. vii. what food? [sidenote: common errors in diet.] [sidenote: beef tea.] [sidenote: eggs.] [sidenote: meat without vegetables.] [sidenote: arrowroot.] i will mention one or two of the most common errors among women in charge of sick respecting sick diet. one is the belief that beef tea is the most nutritive of all articles. now, just try and boil down a lb. of beef into beef tea, evaporate your beef tea, and see what is left of your beef. you will find that there is barely a teaspoonful of solid nourishment to half a pint of water in beef tea;--nevertheless there is a certain reparative quality in it, we do not know what, as there is in tea;--but it may safely be given in almost any inflammatory disease, and is as little to be depended upon with the healthy or convalescent where much nourishment is required. again, it is an ever ready saw that an egg is equivalent to a lb. of meat,--whereas it is not at all so. also, it is seldom noticed with how many patients, particularly of nervous or bilious temperament, eggs disagree. all puddings made with eggs, are distasteful to them in consequence. an egg, whipped up with wine, is often the only form in which they can take this kind of nourishment. again, if the patient has attained to eating meat, it is supposed that to give him meat is the only thing needful for his recovery; whereas scorbutic sores have been actually known to appear among sick persons living in the midst of plenty in england, which could be traced to no other source than this, viz.: that the nurse, depending on meat alone, had allowed the patient to be without vegetables for a considerable time, these latter being so badly cooked that he always left them untouched. arrowroot is another grand dependence of the nurse. as a vehicle for wine, and as a restorative quickly prepared, it is all very well. but it is nothing but starch and water. flour is both more nutritive, and less liable to ferment, and is preferable wherever it can be used. [sidenote: milk, butter, cream, &c.] again, milk and the preparations from milk, are a most important article of food for the sick. butter is the lightest kind of animal fat, and though it wants the sugar and some of the other elements which there are in milk, yet it is most valuable both in itself and in enabling the patient to eat more bread. flour, oats, groats, barley, and their kind, are as we have already said, preferable in all their preparations to all the preparations of arrow root, sago, tapioca, and their kind. cream, in many long chronic diseases, is quite irreplaceable by any other article whatever. it seems to act in the same manner as beef tea, and to most it is much easier of digestion than milk. in fact, it seldom disagrees. cheese is not usually digestible by the sick, but it is pure nourishment for repairing waste; and i have seen sick, and not a few either, whose craving for cheese shewed how much it was needed by them.[ ] but, if fresh milk is so valuable a food for the sick, the least change or sourness in it, makes it of all articles, perhaps, the most injurious; diarrhoea is a common result of fresh milk allowed to become at all sour. the nurse therefore ought to exercise her utmost care in this. in large institutions for the sick, even the poorest, the utmost care is exercised. wenham lake ice is used for this express purpose every summer, while the private patient, perhaps, never tastes a drop of milk that is not sour, all through the hot weather, so little does the private nurse understand the necessity of such care. yet, if you consider that the only drop of real nourishment in your patient's tea is the drop of milk, and how much almost all english patients depend upon their tea, you will see the great importance of not depriving your patient of this drop of milk. buttermilk, a totally different thing, is often very useful, especially in fevers. [sidenote: sweet things.] in laying down rules of diet, by the amounts of "solid nutriment" in different kinds of food, it is constantly lost sight of what the patient requires to repair his waste, what he can take and what he can't. you cannot diet a patient from a book, you cannot make up the human body as you would make up a prescription,--so many parts "carboniferous," so many parts "nitrogenous" will constitute a perfect diet for the patient. the nurse's observation here will materially assist the doctor--the patient's "fancies" will materially assist the nurse. for instance, sugar is one of the most nutritive of all articles, being pure carbon, and is particularly recommended in some books. but the vast majority of all patients in england, young and old, male and female, rich and poor, hospital and private, dislike sweet things,--and while i have never known a person take to sweets when he was ill who disliked them when he was well, i have known many fond of them when in health, who in sickness would leave off anything sweet, even to sugar in tea,--sweet puddings, sweet drinks, are their aversion; the furred tongue almost always likes what is sharp or pungent. scorbutic patients are an exception, they often crave for sweetmeats and jams. [sidenote: jelly.] jelly is another article of diet in great favour with nurses and friends of the sick; even if it could be eaten solid, it would not nourish, but it is simply the height of folly to take / oz. of gelatine and make it into a certain bulk by dissolving it in water and then to give it to the sick, as if the mere bulk represented nourishment. it is now known that jelly does not nourish, that it has a tendency to produce diarrhoea,--and to trust to it to repair the waste of a diseased constitution is simply to starve the sick under the guise of feeding them. if spoonfuls of jelly were given in the course of the day, you would have given one spoonful of gelatine, which spoonful has no nutritive power whatever. and, nevertheless, gelatine contains a large quantity of nitrogen, which is one of the most powerful elements in nutrition; on the other hand, beef tea may be chosen as an illustration of great nutrient power in sickness, co-existing with a very small amount of solid nitrogenous matter. [sidenote: beef tea.] dr. christison says that "every one will be struck with the readiness with which" certain classes of "patients will often take diluted meat juice or beef tea repeatedly, when they refuse all other kinds of food." this is particularly remarkable in "cases of gastric fever, in which," he says, "little or nothing else besides beef tea or diluted meat juice" has been taken for weeks or even months, "and yet a pint of beef tea contains scarcely / oz. of anything but water,"--the result is so striking that he asks what is its mode of action? "not simply nutrient-- / oz. of the most nutritive material cannot nearly replace the daily wear and tear of the tissues in any circumstances. possibly," he says, "it belongs to a new denomination of remedies." it has been observed that a small quantity of beef tea added to other articles of nutrition augments their power out of all proportion to the additional amount of solid matter. the reason why jelly should be innutritious and beef tea nutritious to the sick, is a secret yet undiscovered, but it clearly shows that careful observation of the sick is the only clue to the best dietary. [sidenote: observation, not chemistry, must decide sick diet.] chemistry has as yet afforded little insight into the dieting of sick. all that chemistry can tell us is the amount of "carboniferous" or "nitrogenous" elements discoverable in different dietetic articles. it has given us lists of dietetic substances, arranged in the order of their richness in one or other of these principles; but that is all. in the great majority of cases, the stomach of the patient is guided by other principles of selection than merely the amount of carbon or nitrogen in the diet. no doubt, in this as in other things, nature has very definite rules for her guidance, but these rules can only be ascertained by the most careful observation at the bed-side. she there teaches us that living chemistry, the chemistry of reparation, is something different from the chemistry of the laboratory. organic chemistry is useful, as all knowledge is, when we come face to face with nature; but it by no means follows that we should learn in the laboratory any one of the reparative processes going on in disease. again, the nutritive power of milk and of the preparations from milk, is very much undervalued; there is nearly as much nourishment in half a pint of milk as there is in a quarter of a lb. of meat. but this is not the whole question or nearly the whole. the main question is what the patient's stomach can assimilate or derive nourishment from, and of this the patient's stomach is the sole judge. chemistry cannot tell this. the patient's stomach must be its own chemist. the diet which will keep the healthy man healthy, will kill the sick one. the same beef which is the most nutritive of all meat and which nourishes the healthy man, is the least nourishing of all food to the sick man, whose half-dead stomach can _assimilate_ no part of it, that is, make no food out of it. on a diet of beef tea healthy men on the other hand speedily lose their strength. [sidenote: home-made bread.] i have known patients live for many months without touching bread, because they could not eat baker's bread. these were mostly country patients, but not all. home-made bread or brown bread is a most important article of diet for many patients. the use of aperients may be entirely superseded by it. oat cake is another. [sidenote: sound observation has scarcely yet been brought to bear on sick diet.] to watch for the opinions, then, which the patient's stomach gives, rather than to read "analyses of foods," is the business of all those who have to settle what the patient is to eat--perhaps the most important thing to be provided for him after the air he is to breathe. now the medical man who sees the patient only once a day or even only once or twice a week, cannot possibly tell this without the assistance of the patient himself, or of those who are in constant observation on the patient. the utmost the medical man can tell is whether the patient is weaker or stronger at this visit than he was at the last visit. i should therefore say that incomparably the most important office of the nurse, after she has taken care of the patient's air, is to take care to observe the effect of his food, and report it to the medical attendant. it is quite incalculable the good that would certainly come from such _sound_ and close observation in this almost neglected branch of nursing, or the help it would give to the medical man. [sidenote: tea and coffee.] a great deal too much against tea[ ] is said by wise people, and a great deal too much of tea is given to the sick by foolish people. when you see the natural and almost universal craving in english sick for their "tea," you cannot but feel that nature knows what she is about. but a little tea or coffee restores them quite as much as a great deal, and a great deal of tea and especially of coffee impairs the little power of digestion they have. yet a nurse because she sees how one or two cups of tea or coffee restores her patient, thinks that three or four cups will do twice as much. this is not the case at all; it is however certain that there is nothing yet discovered which is a substitute to the english patient for his cup of tea; he can take it when he can take nothing else, and he often can't take anything else if he has it not. i should be very glad if any of the abusers of tea would point out what to give to an english patient after a sleepless night, instead of tea. if you give it at or o'clock in the morning, he may even sometimes fall asleep after it, and get perhaps his only two or three hours' sleep during the twenty-four. at the same time you never should give tea or coffee to the sick, as a rule, after o'clock in the afternoon. sleeplessness in the early night is from excitement generally and is increased by tea or coffee; sleeplessness which continues to the early morning is from exhaustion often, and is relieved by tea. the only english patients i have ever known refuse tea, have been typhus cases, and the first sign of their getting better was their craving again for tea. in general, the dry and dirty tongue always prefers tea to coffee, and will quite decline milk, unless with tea. coffee is a better restorative than tea, but a greater impairer of the digestion. let the patient's taste decide. you will say that, in cases of great thirst, the patient's craving decides that it will drink _a great deal_ of tea, and that you cannot help it. but in these cases be sure that the patient requires diluents for quite other purposes than quenching the thirst; he wants a great deal of some drink, not only of tea, and the doctor will order what he is to have, barley water or lemonade, or soda water and milk, as the case may be. lehmann, quoted by dr. christison, says that, among the well and active "the infusion of oz. of roasted coffee daily will diminish the waste" going on in the body "by one-fourth," and dr. christison adds that tea has the same property. now this is actual experiment. lehmann weighs the man and finds the fact from his weight. it is not deduced from any "analysis" of food. all experience among the sick shows the same thing.[ ] [sidenote: cocoa.] cocoa is often recommended to the sick in lieu of tea or coffee. but independently of the fact that english sick very generally dislike cocoa, it has quite a different effect from tea or coffee. it is an oily starchy nut having no restorative power at all, but simply increasing fat. it is pure mockery of the sick, therefore, to call it a substitute for tea. for any renovating stimulus it has, you might just as well offer them chesnuts instead of tea. [sidenote: bulk.] an almost universal error among nurses is in the bulk of the food and especially the drinks they offer to their patients. suppose a patient ordered oz. brandy during the day, how is he to take this if you make it into four pints with diluting it? the same with tea and beef tea, with arrowroot, milk, &c. you have not increased the nourishment, you have not increased the renovating power of these articles, by increasing their bulk,--you have very likely diminished both by giving the patient's digestion more to do, and most likely of all, the patient will leave half of what he has been ordered to take, because he cannot swallow the bulk with which you have been pleased to invest it. it requires very nice observation and care (and meets with hardly any) to determine what will not be too thick or strong for the patient to take, while giving him no more than the bulk which he is able to swallow. viii. bed and bedding. [sidenote: feverishness a symptom of bedding.] a few words upon bedsteads and bedding; and principally as regards patients who are entirely, or almost entirely, confined to bed. feverishness is generally supposed to be a symptom of fever--in nine cases out of ten it is a symptom of bedding.[ ] the patient has had re-introduced into the body the emanations from himself which day after day and week after week saturate his unaired bedding. how can it be otherwise? look at the ordinary bed in which a patient lies. [sidenote: uncleanliness of ordinary bedding.] if i were looking out for an example in order to show what _not_ to do, i should take the specimen of an ordinary bed in a private house: a wooden bedstead, two or even three mattresses piled up to above the height of a table; a vallance attached to the frame--nothing but a miracle could ever thoroughly dry or air such a bed and bedding. the patient must inevitably alternate between cold damp after his bed is made, and warm damp before, both saturated with organic matter,[ ] and this from the time the mattresses are put under him till the time they are picked to pieces, if this is ever done. [sidenote: air your dirty sheets, not only your clean ones.] if you consider that an adult in health exhales by the lungs and skin in the twenty-four hours three pints at least of moisture, loaded with organic matter ready to enter into putrefaction; that in sickness the quantity is often greatly increased, the quality is always more noxious--just ask yourself next where does all this moisture go to? chiefly into the bedding, because it cannot go anywhere else. and it stays there; because, except perhaps a weekly change of sheets, scarcely any other airing is attempted. a nurse will be careful to fidgetiness about airing the clean sheets from clean damp, but airing the dirty sheets from noxious damp will never even occur to her. besides this, the most dangerous effluvia we know of are from the excreta of the sick--these are placed, at least temporarily, where they must throw their effluvia into the under side of the bed, and the space under the bed is never aired; it cannot be, with our arrangements. must not such a bed be always saturated, and be always the means of re-introducing into the system of the unfortunate patient who lies in it, that excrementitious matter to eliminate which from the body nature had expressly appointed the disease? my heart always sinks within me when i hear the good house-wife, of every class, say, "i assure you the bed has been well slept in," and i can only hope it is not true. what? is the bed already saturated with somebody else's damp before my patient comes to exhale into it his own damp? has it not had a single chance to be aired? no, not one. "it has been slept in every night." [sidenote: iron spring bedstead the best.] [sidenote: comfort and cleanliness of _two_ beds.] the only way of really nursing a real patient is to have an _iron_ bedstead, with rheocline springs, which are permeable by the air up to the very mattress (no vallance, of course), the mattress to be a thin hair one; the bed to be not above - / feet wide. if the patient be entirely confined to his bed, there should be _two_ such bedsteads; each bed to be "made" with mattress, sheets, blankets, &c., complete--the patient to pass twelve hours in each bed; on no account to carry his sheets with him. the whole of the bedding to be hung up to air for each intermediate twelve hours. of course there are many cases where this cannot be done at all--many more where only an approach to it can be made. i am indicating the ideal of nursing, and what i have actually had done. but about the kind of bedstead there can be no doubt, whether there be one or two provided. [sidenote: bed not to be too wide.] there is a prejudice in favour of a wide bed--i believe it to be a prejudice. all the refreshment of moving a patient from one side to the other of his bed is far more effectually secured by putting him into a fresh bed; and a patient who is really very ill does not stray far in bed. but it is said there is no room to put a tray down on a narrow bed. no good nurse will ever put a tray on a bed at all. if the patient can turn on his side, he will eat more comfortably from a bed-side table; and on no account whatever should a bed ever be higher than a sofa. otherwise the patient feels himself "out of humanity's reach"; he can get at nothing for himself: he can move nothing for himself. if the patient cannot turn, a table over the bed is a better thing. i need hardly say that a patient's bed should never have its side against the wall. the nurse must be able to get easily to both sides the bed, and to reach easily every part of the patient without stretching--a thing impossible if the bed be either too wide or too high. [sidenote: bed not to be too high.] when i see a patient in a room nine or ten feet high upon a bed between four and five feet high, with his head, when he is sitting up in bed, actually within two or three feet of the ceiling, i ask myself, is this expressly planned to produce that peculiarly distressing feeling common to the sick, viz., as if the walls and ceiling were closing in upon them, and they becoming sandwiches between floor and ceiling, which imagination is not, indeed, here so far from the truth? if, over and above this, the window stops short of the ceiling, then the patient's head may literally be raised above the stratum of fresh air, even when the window is open. can human perversity any farther go, in unmaking the process of restoration which god has made? the fact is, that the heads of sleepers or of sick should never be higher than the throat of the chimney, which ensures their being in the current of best air. and we will not suppose it possible that you have closed your chimney with a chimney-board. if a bed is higher than a sofa, the difference of the fatigue of getting in and out of bed will just make the difference, very often, to the patient (who can get in and out of bed at all) of being able to take a few minutes' exercise, either in the open air or in another room. it is so very odd that people never think of this, or of how many more times a patient who is in bed for the twenty-four hours is obliged to get in and out of bed than they are, who only, it is to be hoped, get into bed once and out of bed once during the twenty-four hours. [sidenote: nor in a dark place.] a patient's bed should always be in the lightest spot in the room; and he should be able to see out of window. [sidenote: nor a four poster with curtains.] i need scarcely say that the old four-post bed with curtains is utterly inadmissible, whether for sick or well. hospital bedsteads are in many respects very much less objectionable than private ones. [sidenote: scrofula often a result of disposition of bedclothes.] there is reason to believe that not a few of the apparently unaccountable cases of scrofula among children proceed from the habit of sleeping with the head under the bed clothes, and so inhaling air already breathed, which is farther contaminated by exhalations from the skin. patients are sometimes given to a similar habit, and it often happens that the bed clothes are so disposed that the patient must necessarily breathe air more or less contaminated by exhalations from his skin. a good nurse will be careful to attend to this. it is an important part, so to speak, of ventilation. [sidenote: bed sores.] it may be worth while to remark, that where there is any danger of bed-sores a blanket should never be placed _under_ the patient. it retains damp and acts like a poultice. [sidenote: heavy and impervious bedclothes.] never use anything but light witney blankets as bed covering for the sick. the heavy cotton impervious counterpane is bad, for the very reason that it keeps in the emanations from the sick person, while the blanket allows them to pass through. weak patients are invariably distressed by a great weight of bed-clothes, which often prevents their getting any sound sleep whatever. note.--one word about pillows. every weak patient, be his illness what it may, suffers more or less from difficulty in breathing. to take the weight of the body off the poor chest, which is hardly up to its work as it is, ought therefore to be the object of the nurse in arranging his pillows. now what does she do and what are the consequences? she piles the pillows one a-top of the other like a wall of bricks. the head is thrown upon the chest. and the shoulders are pushed forward, so as not to allow the lungs room to expand. the pillows, in fact, lean upon the patient, not the patient upon the pillows. it is impossible to give a rule for this, because it must vary with the figure of the patient. and tall patients suffer much more than short ones, because of the _drag_ of the long limbs upon the waist. but the object is to support, with the pillows, the back _below_ the breathing apparatus, to allow the shoulders room to fall back, and to support the head, without throwing it forward. the suffering of dying patients is immensely increased by neglect of these points. and many an invalid, too weak to drag about his pillows himself, slips his book or anything at hand behind the lower part of his back to support it. ix. light. [sidenote: light essential to both health and recovery.] it is the unqualified result of all my experience with the sick, that second only to their need of fresh air is their need of light; that, after a close room, what hurts them most is a dark room. and that it is not only light but direct sun-light they want. i had rather have the power of carrying my patient about after the sun, according to the aspect of the rooms, if circumstances permit, than let him linger in a room when the sun is off. people think the effect is upon the spirits only. this is by no means the case. the sun is not only a painter but a sculptor. you admit that he does the photograph. without going into any scientific exposition we must admit that light has quite as real and tangible effects upon the human body. but this is not all. who has not observed the purifying effect of light, and especially of direct sunlight, upon the air of a room? here is an observation within everybody's experience. go into a room where the shutters are always shut, (in a sick room or a bedroom there should never be shutters shut), and though the room be uninhabited, though the air has never been polluted by the breathing of human beings, you will observe a close, musty smell of corrupt air, of air i.e. unpurified by the effect of the sun's rays. the mustiness of dark rooms and corners, indeed, is proverbial. the cheerfulness of a room, the usefulness of light in treating disease is all-important. [sidenote: aspect, view, and sunlight matters of first importance to the sick.] a very high authority in hospital construction has said that people do not enough consider the difference between wards and dormitories in planning their buildings. but i go farther, and say, that healthy people never remember the difference between _bed_-rooms and _sick_-rooms, in making arrangements for the sick. to a sleeper in health it does not signify what the view is from his bed. he ought never to be in it excepting when asleep, and at night. aspect does not very much signify either (provided the sun reach his bed-room some time in every day, to purify the air), because he ought never to be in his bed-room except during the hours when there is no sun. but the case is exactly reversed with the sick, even should they be as many hours out of their beds as you are in yours, which probably they are not. therefore, that they should be able, without raising themselves or turning in bed, to see out of window from their beds, to see sky and sun-light at least, if you can show them nothing else, i assert to be, if not of the very first importance for recovery, at least something very near it. and you should therefore look to the position of the beds of your sick one of the very first things. if they can see out of two windows instead of one, so much the better. again, the morning sun and the mid-day sun--the hours when they are quite certain not to be up, are of more importance to them, if a choice must be made, than the afternoon sun. perhaps you can take them out of bed in the afternoon and set them by the window, where they can see the sun. but the best rule is, if possible, to give them direct sun-light from the moment he rises till the moment he sets. another great difference between the _bed_-room and the _sick_-room is, that the _sleeper_ has a very large balance of fresh air to begin with, when he begins the night, if his room has been open all day as it ought to be; the _sick_ man has not, because all day he has been breathing the air in the same room, and dirtying it by the emanations from himself. far more care is therefore necessary to keep up a constant change of air in the sick room. it is hardly necessary to add that there are acute cases, (particularly a few ophthalmic cases, and diseases where the eye is morbidly sensitive), where a subdued light is necessary. but a dark north room is inadmissible even for these. you can always moderate the light by blinds and curtains. heavy, thick, dark window or bed curtains should, however, hardly ever be used for any kind of sick in this country. a light white curtain at the head of the bed is, in general, all that is necessary, and a green blind to the window, to be drawn down only when necessary. [sidenote: without sunlight, we degenerate body and mind.] one of the greatest observers of human things (not physiological), says, in another language, "where there is sun there is thought." all physiology goes to confirm this. where is the shady side of deep valleys, there is cretinism. where are cellars and the unsunned sides of narrow streets, there is the degeneracy and weakliness of the human race--mind and body equally degenerating. put the pale withering plant and human being into the sun, and, if not too far gone, each will recover health and spirit. [sidenote: almost all patients lie with their faces to the light.] it is a curious thing to observe how almost all patients lie with their faces turned to the light, exactly as plants always make their faces turned to the light; a patient will even complain that it gives him pain "lying on that side." "then why _do_ you lie on that side?" he does not know,--but we do. it is because it is the side towards the window. a fashionable physician has recently published in a government report that he always turns his patients' faces from the light. yes, but nature is stronger than fashionable physicians, and depend upon it she turns the faces back and _towards_ such light as she can get. walk through the wards of a hospital, remember the bed sides of private patients you have seen, and count how many sick you ever saw lying with their faces towards the wall. x. cleanliness of rooms and walls. [sidenote: cleanliness of carpets and furniture.] it cannot be necessary to tell a nurse that she should be clean, or that she should keep her patient clean,--seeing that the greater part of nursing consists in preserving cleanliness. no ventilation can freshen a room or ward where the most scrupulous cleanliness is not observed. unless the wind be blowing through the windows at the rate of twenty miles an hour, dusty carpets, dirty wainscots, musty curtains and furniture, will infallibly produce a close smell. i have lived in a large and expensively furnished london house, where the only constant inmate in two very lofty rooms, with opposite windows, was myself, and yet, owing to the abovementioned dirty circumstances, no opening of windows could ever keep those rooms free from closeness; but the carpet and curtains having been turned out of the rooms altogether, they became instantly as fresh as could be wished. it is pure nonsense to say that in london a room cannot be kept clean. many of our hospitals show the exact reverse. [sidenote: dust never removed now.] but no particle of dust is ever or can ever be removed or really got rid of by the present system of dusting. dusting in these days means nothing but flapping the dust from one part of a room on to another with doors and windows closed. what you do it for i cannot think. you had much better leave the dust alone, if you are not going to take it away altogether. for from the time a room begins to be a room up to the time when it ceases to be one, no one atom of dust ever actually leaves its precincts. tidying a room means nothing now but removing a thing from one place, which it has kept clean for itself, on to another and a dirtier one.[ ] flapping by way of cleaning is only admissible in the case of pictures, or anything made of paper. the only way i know to _remove_ dust, the plague of all lovers of fresh air, is to wipe everything with a damp cloth. and all furniture ought to be so made as that it may be wiped with a damp cloth without injury to itself, and so polished as that it may be damped without injury to others. to dust, as it is now practised, truly means to distribute dust more equally over a room. [sidenote: floors.] as to floors, the only really clean floor i know is the berlin _lackered_ floor, which is wet rubbed and dry rubbed every morning to remove the dust. the french _parquet_ is always more or less dusty, although infinitely superior in point of cleanliness and healthiness to our absorbent floor. for a sick room, a carpet is perhaps the worst expedient which could by any possibility have been invented. if you must have a carpet, the only safety is to take it up two or three times a year, instead of once. a dirty carpet literally infects the room. and if you consider the enormous quantity of organic matter from the feet of people coming in, which must saturate it, this is by no means surprising. [sidenote: papered, plastered, oil-painted walls.] as for walls, the worst is the papered wall; the next worst is plaster. but the plaster can be redeemed by frequent lime-washing; the paper requires frequent renewing. a glazed paper gets rid of a good deal of the danger. but the ordinary bed-room paper is all that it ought _not_ to be.[ ] the close connection between ventilation and cleanliness is shown in this. an ordinary light paper will last clean much longer if there is an arnott's ventilator in the chimney than it otherwise would. the best wall now extant is oil paint. from this you can wash the animal exuviæ.[ ] these are what make a room musty. [sidenote: best kind of wall for a sick-room.] the best wall for a sick-room or ward that could be made is pure white non-absorbent cement or glass, or glazed tiles, if they were made sightly enough. air can be soiled just like water. if you blow into water you will soil it with the animal matter from your breath. so it is with air. air is always soiled in a room where walls and carpets are saturated with animal exhalations. want of cleanliness, then, in rooms and wards, which you have to guard against, may arise in three ways. [sidenote: dirty air from without.] . dirty air coming in from without, soiled by sewer emanations, the evaporation from dirty streets, smoke, bits of unburnt fuel, bits of straw, bits of horse dung. [sidenote: best kind of wall for a house.] if people would but cover the outside walls of their houses with plain or encaustic tiles, what an incalculable improvement would there be in light, cleanliness, dryness, warmth, and consequently economy. the play of a fire-engine would then effectually wash the outside of a house. this kind of _walling_ would stand next to paving in improving the health of towns. [sidenote: dirty air from within.] . dirty air coming from within, from dust, which you often displace, but never remove. and this recalls what ought to be a _sine quâ non_. have as few ledges in your room or ward as possible. and under no pretence have any ledge whatever out of sight. dust accumulates there, and will never be wiped off. this is a certain way to soil the air. besides this, the animal exhalations from your inmates saturate your furniture. and if you never clean your furniture properly, how can your rooms or wards be anything but musty? ventilate as you please, the rooms will never be sweet. besides this, there is a constant _degradation_, as it is called, taking place from everything except polished or glazed articles--_e.g._, in colouring certain green papers arsenic is used. now in the very dust even, which is lying about in rooms hung with this kind of green paper, arsenic has been distinctly detected. you see your dust is anything but harmless; yet you will let such dust lie about your ledges for months, your rooms for ever. again, the fire fills the room with coal-dust. [sidenote: dirty air from the carpet.] . dirty air coming from the carpet. above all, take care of the carpets, that the animal dirt left there by the feet of visitors does not stay there. floors, unless the grain is filled up and polished, are just as bad. the smell from the floor of a school-room or ward, when any moisture brings out the organic matter by which it is saturated, might alone be enough to warn us of the mischief that is going on. [sidenote: remedies.] the outer air, then, can only be kept clean by sanitary improvements, and by consuming smoke. the expense in soap, which this single improvement would save, is quite incalculable. the inside air can only be kept clean by excessive care in the ways mentioned above--to rid the walls, carpets, furniture, ledges, &c., of the organic matter and dust--dust consisting greatly of this organic matter--with which they become saturated, and which is what really makes the room musty. without cleanliness, you cannot have all the effect of ventilation; without ventilation, you can have no thorough cleanliness. very few people, be they of what class they may, have any idea of the exquisite cleanliness required in the sick-room. for much of what i have said applies less to the hospital than to the private sick-room. the smoky chimney, the dusty furniture, the utensils emptied but once a day, often keep the air of the sick constantly dirty in the best private houses. the well have a curious habit of forgetting that what is to them but a trifling inconvenience, to be patiently "put up" with, is to the sick a source of suffering, delaying recovery, if not actually hastening death. the well are scarcely ever more than eight hours, at most, in the same room. some change they can always make, if only for a few minutes. even during the supposed eight hours, they can change their posture or their position in the room. but the sick man, who never leaves his bed, who cannot change by any movement of his own his air, or his light, or his warmth; who cannot obtain quiet, or get out of the smoke, or the smell, or the dust; he is really poisoned or depressed by what is to you the merest trifle. "what can't be cured must be endured," is the very worst and most dangerous maxim for a nurse which ever was made. patience and resignation in her are but other words for carelessness or indifference--contemptible, if in regard to herself; culpable, if in regard to her sick. xi. personal cleanliness. [sidenote: poisoning by the skin.] in almost all diseases, the function of the skin is, more or less, disordered; and in many most important diseases nature relieves herself almost entirely by the skin. this is particularly the case with children. but the excretion, which comes from the skin, is left there, unless removed by washing or by the clothes. every nurse should keep this fact constantly in mind,--for, if she allow her sick to remain unwashed, or their clothing to remain on them after being saturated with perspiration or other excretion, she is interfering injuriously with the natural processes of health just as effectually as if she were to give the patient a dose of slow poison by the mouth. poisoning by the skin is no less certain than poisoning by the mouth--only it is slower in its operation. [sidenote: ventilation and skin-cleanliness equally essential.] the amount of relief and comfort experienced by sick after the skin has been carefully washed and dried, is one of the commonest observations made at a sick bed. but it must not be forgotten that the comfort and relief so obtained are not all. they are, in fact, nothing more than a sign that the vital powers have been relieved by removing something that was oppressing them. the nurse, therefore, must never put off attending to the personal cleanliness of her patient under the plea that all that is to be gained is a little relief, which can be quite as well given later. in all well-regulated hospitals this ought to be, and generally is, attended to. but it is very generally neglected with private sick. just as it is necessary to renew the air round a sick person frequently, to carry off morbid effluvia from the lungs and skin, by maintaining free ventilation, so is it necessary to keep the pores of the skin free from all obstructing excretions. the object, both of ventilation and of skin-cleanliness, is pretty much the same, to wit, removing noxious matter from the system as rapidly as possible. care should be taken in all these operations of sponging, washing, and cleansing the skin, not to expose too great a surface at once, so as to check the perspiration, which would renew the evil in another form. the various ways of washing the sick need not here be specified,--the less so as the doctors ought to say which is to be used. in several forms of diarrhoea, dysentery, &c., where the skin is hard and harsh, the relief afforded by washing with a great deal of soft soap is incalculable. in other cases, sponging with tepid soap and water, then with tepid water and drying with a hot towel will be ordered. every nurse ought to be careful to wash her hands very frequently during the day. if her face too, so much the better. one word as to cleanliness merely as cleanliness. [sidenote: steaming and rubbing the skin.] compare the dirtiness of the water in which you have washed when it is cold without soap, cold with soap, hot with soap. you will find the first has hardly removed any dirt at all, the second a little more, the third a great deal more. but hold your hand over a cup of hot water for a minute or two, and then, by merely rubbing with the finger, you will bring off flakes of dirt or dirty skin. after a vapour bath you may peel your whole self clean in this way. what i mean is, that by simply washing or sponging with water you do not really clean your skin. take a rough towel, dip one corner in very hot water,--if a little spirit be added to it it will be more effectual,--and then rub as if you were rubbing the towel into your skin with your fingers. the black flakes which will come off will convince you that you were not clean before, however much soap and water you have used. these flakes are what require removing. and you can really keep yourself cleaner with a tumbler of hot water and a rough towel and rubbing, than with a whole apparatus of bath and soap and sponge, without rubbing. it is quite nonsense to say that anybody need be dirty. patients have been kept as clean by these means on a long voyage, when a basin full of water could not be afforded, and when they could not be moved out of their berths, as if all the appurtenances of home had been at hand. washing, however, with a large quantity of water has quite other effects than those of mere cleanliness. the skin absorbs the water and becomes softer and more perspirable. to wash with soap and soft water is, therefore, desirable from other points of view than that of cleanliness. xii. chattering hopes and advices. [sidenote: advising the sick.] the sick man to his advisers. "my advisers! their name is legion. * * * somehow or other, it seems a provision of the universal destinies, that every man, woman, and child should consider him, her, or itself privileged especially to advise me. why? that is precisely what i want to know." and this is what i have to say to them. i have been advised to go to every place extant in and out of england--to take every kind of exercise by every kind of cart, carriage--yes, and even swing (!) and dumb-bell (!) in existence; to imbibe every different kind of stimulus that ever has been invented. and this when those _best_ fitted to know, viz., medical men, after long and close attendance, had declared any journey out of the question, had prohibited any kind of motion whatever, had closely laid down the diet and drink. what would my advisers say, were they the medical attendants, and i the patient left their advice, and took the casual adviser's? but the singularity in legion's mind is this: it never occurs to him that everybody else is doing the same thing, and that i the patient _must_ perforce say, in sheer self-defence, like rosalind, "i could not do with all." [sidenote: chattering hopes the bane of the sick.] "chattering hopes" may seem an odd heading. but i really believe there is scarcely a greater worry which invalids have to endure than the incurable hopes of their friends. there is no one practice against which i can speak more strongly from actual personal experience, wide and long, of its effects during sickness observed both upon others and upon myself. i would appeal most seriously to all friends, visitors, and attendants of the sick to leave off this practice of attempting to "cheer" the sick by making light of their danger and by exaggerating their probabilities of recovery. far more now than formerly does the medical attendant tell the truth to the sick who are really desirous to hear it about their own state. how intense is the folly, then, to say the least of it, of the friend, be he even a medical man, who thinks that his opinion, given after a cursory observation, will weigh with the patient, against the opinion of the medical attendant, given, perhaps, after years of observation, after using every help to diagnosis afforded by the stethoscope, the examination of pulse, tongue, &c.; and certainly after much more observation than the friend can possibly have had. supposing the patient to be possessed of common sense,--how can the "favourable" opinion, if it is to be called an opinion at all, of the casual visitor "cheer" him,--when different from that of the experienced attendant? unquestionably the latter may, and often does, turn out to be wrong. but which is most likely to be wrong? [sidenote: patient does not want to talk of himself.] the fact is, that the patient[ ] is not "cheered" at all by these well-meaning, most tiresome friends. on the contrary, he is depressed and wearied. if, on the one hand, he exerts himself to tell each successive member of this too numerous conspiracy, whose name is legion, why he does not think as they do,--in what respect he is worse,--what symptoms exist that they know nothing of,--he is fatigued instead of "cheered," and his attention is fixed upon himself. in general, patients who are really ill, do not want to talk about themselves. hypochondriacs do, but again i say we are not on the subject of hypochondriacs. [sidenote: absurd consolations put forth for the benefit of the sick.] if, on the other hand, and which is much more frequently the case, the patient says nothing, but the shakespearian "oh!" "ah!" "go to!" and "in good sooth!" in order to escape from the conversation about himself the sooner, he is depressed by want of sympathy. he feels isolated in the midst of friends. he feels what a convenience it would be, if there were any single person to whom he could speak simply and openly, without pulling the string upon himself of this shower-bath of silly hopes and encouragements; to whom he could express his wishes and directions without that person persisting in saying "i hope that it will please god yet to give you twenty years," or, "you have a long life of activity before you." how often we see at the end of biographies or of cases recorded in medical papers, "after a long illness a. died rather suddenly," or, "unexpectedly both to himself and to others." "unexpectedly" to others, perhaps, who did not see, because they did not look; but by no means "unexpectedly to himself," as i feel entitled to believe, both from the internal evidence in such stories, and from watching similar cases: there was every reason to expect that a. would die, and he knew it; but he found it useless to insist upon his own knowledge to his friends. in these remarks i am alluding neither to acute cases which terminate rapidly nor to "nervous" cases. by the first much interest in their own danger is very rarely felt. in writings of fiction, whether novels or biographies, these death-beds are generally depicted as almost seraphic in lucidity of intelligence. sadly large has been my experience in death-beds, and i can only say that i have seldom or never seen such. indifference, excepting with regard to bodily suffering, or to some duty the dying man desires to perform, is the far more usual state. the "nervous case," on the other hand, delights in figuring to himself and others a fictitious danger. but the long chronic case, who knows too well himself, and who has been told by his physician that he will never enter active life again, who feels that every month he has to give up something he could do the month before--oh! spare such sufferers your chattering hopes. you do not know how you worry and weary them. such real sufferers cannot bear to talk of themselves, still less to hope for what they cannot at all expect. so also as to all the advice showered so profusely upon such sick, to leave off some occupation, to try some other doctor, some other house, climate, pill, powder, or specific; i say nothing of the inconsistency--for these advisers are sure to be the same persons who exhorted the sick man not to believe his own doctor's prognostics, because "doctors are always mistaken," but to believe some other doctor, because "this doctor is always right." sure also are these advisers to be the persons to bring the sick man fresh occupation, while exhorting him to leave his own. [sidenote: wonderful presumption of the advisers of the sick.] wonderful is the face with which friends, lay and medical, will come in and worry the patient with recommendations to do something or other, having just as little knowledge as to its being feasible, or even safe for him, as if they were to recommend a man to take exercise, not knowing he had broken his leg. what would the friend say, if _he_ were the medical attendant, and if the patient, because some _other_ friend had come in, because somebody, anybody, nobody, had recommended something, anything, nothing, were to disregard _his_ orders, and take that other body's recommendation? but people never think of this. [sidenote: advisers the same now as two hundred years ago.] a celebrated historical personage has related the commonplaces which, when on the eve of executing a remarkable resolution, were showered in nearly the same words by every one around successively for a period of six months. to these the personage states that it was found least trouble always to reply the same thing, viz., that it could not be supposed that such a resolution had been taken without sufficient previous consideration. to patients enduring every day for years from every friend or acquaintance, either by letter or _vivâ voce_, some torment of this kind, i would suggest the same answer. it would indeed be spared, if such friends and acquaintances would but consider for one moment, that it is probable the patient has heard such advice at least fifty times before, and that, had it been practicable, it would have been practised long ago. but of such consideration there appears to be no chance. strange, though true, that people should be just the same in these things as they were a few hundred years ago! to me these commonplaces, leaving their smear upon the cheerful, single-hearted, constant devotion to duty, which is so often seen in the decline of such sufferers, recall the slimy trail left by the snail on the sunny southern garden-wall loaded with fruit. [sidenote: mockery of the advice given to sick.] no mockery in the world is so hollow as the advice showered upon the sick. it is of no use for the sick to say anything, for what the adviser wants is, _not_ to know the truth about the state of the patient, but to turn whatever the sick may say to the support of his own argument, set forth, it must be repeated, without any inquiry whatever into the patient's real condition. "but it would be impertinent or indecent in me to make such an inquiry," says the adviser. true; and how much more impertinent is it to give your advice when you can know nothing about the truth, and admit you could not inquire into it. to nurses i say--these are the visitors who do your patient harm. when you hear him told:-- . that he has nothing the matter with him, and that he wants cheering. . that he is committing suicide, and that he wants preventing. . that he is the tool of somebody who makes use of him for a purpose. . that he will listen to nobody, but is obstinately bent upon his own way; and . that he ought to be called to the sense of duty, and is flying in the face of providence;--then know that your patient is receiving all the injury that he can receive from a visitor. how little the real sufferings of illness are known or understood. how little does any one in good health fancy him or even _her_self into the life of a sick person. [sidenote: means of giving pleasure to the sick.] do, you who are about the sick or who visit the sick, try and give them pleasure, remember to tell them what will do so. how often in such visits the sick person has to do the whole conversation, exerting his own imagination and memory, while you would take the visitor, absorbed in his own anxieties, making no effort of memory or imagination, for the sick person. "oh! my dear, i have so much to think of, i really quite forgot to tell him that; besides, i thought he would know it," says the visitor to another friend. how could "he know it"? depend upon it, the people who say this are really those who have little "to think of." there are many burthened with business who always manage to keep a pigeon-hole in their minds, full of things to tell the "invalid." i do not say, don't tell him your anxieties--i believe it is good for him and good for you too; but if you tell him what is anxious, surely you can remember to tell him what is pleasant too. a sick person does so enjoy hearing good news:--for instance, of a love and courtship, while in progress to a good ending. if you tell him only when the marriage takes place, he loses half the pleasure, which god knows he has little enough of; and ten to one but you have told him of some love-making with a bad ending. a sick person also intensely enjoys hearing of any _material_ good, any positive or practical success of the right. he has so much of books and fiction, of principles, and precepts, and theories; do, instead of advising him with advice he has heard at least fifty times before, tell him of one benevolent act which has really succeeded practically,--it is like a day's health to him.[ ] you have no idea what the craving of sick with undiminished power of thinking, but little power of doing, is to hear of good practical action, when they can no longer partake in it. do observe these things with the sick. do remember how their life is to them disappointed and incomplete. you see them lying there with miserable disappointments, from which they can have no escape but death, and you can't remember to tell them of what would give them so much pleasure, or at least an hour's variety. they don't want you to be lachrymose and whining with them, they like you to be fresh and active and interested, but they cannot bear absence of mind, and they are so tired of the advice and preaching they receive from every body, no matter whom it is, they see. there is no better society than babies and sick people for one another. of course you must manage this so that neither shall suffer from it, which is perfectly possible. if you think the "air of the sick room" bad for the baby, why it is bad for the invalid too, and, therefore, you will of course correct it for both. it freshens up a sick person's whole mental atmosphere to see "the baby." and a very young child, if unspoiled, will generally adapt itself wonderfully to the ways of a sick person, if the time they spend together is not too long. if you knew how unreasonably sick people suffer from reasonable causes of distress, you would take more pains about all these things. an infant laid upon the sick bed will do the sick person, thus suffering, more good than all your logic. a piece of good news will do the same. perhaps you are afraid of "disturbing" him. you say there is no comfort for his present cause of affliction. it is perfectly reasonable. the distinction is this, if he is obliged to act, do not "disturb" him with another subject of thought just yet; help him to do what he wants to do: but, if he _has_ done this, or if nothing _can_ be done, then "disturb" him by all means. you will relieve, more effectually, unreasonable suffering from reasonable causes by telling him "the news," showing him "the baby," or giving him something new to think of or to look at than by all the logic in the world. it has been very justly said that the sick are like children in this, that there is no _proportion_ in events to them. now it is your business as their visitor to restore this right proportion for them--to shew them what the rest of the world is doing. how can they find it out otherwise? you will find them far more open to conviction than children in this. and you will find that their unreasonable intensity of suffering from unkindness, from want of sympathy, &c., will disappear with their freshened interest in the big world's events. but then you must be able to give them real interests, not gossip. [sidenote: two new classes of patients peculiar to this generation.] note.--there are two classes of patients which are unfortunately becoming more common every day, especially among women of the richer orders, to whom all these remarks are pre-eminently inapplicable. . those who make health an excuse for doing nothing, and at the same time allege that the being able to do nothing is their only grief. . those who have brought upon themselves ill-health by over pursuit of amusement, which they and their friends have most unhappily called intellectual activity. i scarcely know a greater injury that can be inflicted than the advice too often given to the first class "to vegetate"--or than the admiration too often bestowed on the latter class for "pluck." xiii. observation of the sick. [sidenote: what is the use of the question, is he better?] there is no more silly or universal question scarcely asked than this, "is he better?" ask it of the medical attendant, if you please. but of whom else, if you wish for a real answer to your question, would you ask it? certainly not of the casual visitor; certainly not of the nurse, while the nurse's observation is so little exercised as it is now. what you want are facts, not opinions--for who can have any opinion of any value as to whether the patient is better or worse, excepting the constant medical attendant, or the really observing nurse? the most important practical lesson that can be given to nurses is to teach them what to observe--how to observe--what symptoms indicate improvement--what the reverse--which are of importance--which are of none--which are the evidence of neglect--and of what kind of neglect. all this is what ought to make part, and an essential part, of the training of every nurse. at present how few there are, either professional or unprofessional, who really know at all whether any sick person they may be with is better or worse. the vagueness and looseness of the information one receives in answer to that much abused question, "is he better?" would be ludicrous, if it were not painful. the only sensible answer (in the present state of knowledge about sickness) would be "how can i know? i cannot tell how he was when i was not with him." i can record but a very few specimens of the answers[ ] which i have heard made by friends and nurses, and accepted by physicians and surgeons at the very bed-side of the patient, who could have contradicted every word, but did not--sometimes from amiability, often from shyness, oftenest from languor! "how often have the bowels acted, nurse?" "once, sir." this generally means that the utensil has been emptied once, it having been used perhaps seven or eight times. "do you think the patient is much weaker than he was six weeks ago?" "oh no, sir; you know it is very long since he has been up and dressed, and he can get across the room now." this means that the nurse has not observed that whereas six weeks ago he sat up and occupied himself in bed, he now lies still doing nothing; that, although he can "get across the room," he cannot stand for five seconds. another patient who is eating well, recovering steadily, although slowly, from fever, but cannot walk or stand, is represented to the doctor as making no progress at all. [sidenote: leading questions useless or misleading.] questions, too, as asked now (but too generally) of or about patients, would obtain no information at all about them, even if the person asked of had every information to give. the question is generally a leading question; and it is singular that people never think what must be the answer to this question before they ask it: for instance, "has he had a good night?" now, one patient will think he has a bad night if he has not slept ten hours without waking. another does not think he has a bad night if he has had intervals of dosing occasionally. the same answer has actually been given as regarded two patients--one who had been entirely sleepless for five times twenty-four hours, and died of it, and another who had not slept the sleep of a regular night, without waking. why cannot the question be asked, how many hours' sleep has ---- had? and at what hours of the night?[ ] "i have never closed my eyes all night," an answer as frequently made when the speaker has had several hours' sleep as when he has had none, would then be less often said. lies, intentional and unintentional, are much seldomer told in answer to precise than to leading questions. another frequent error is to inquire whether one cause remains, and not whether the effect which may be produced by a great many different causes, _not_ inquired after, remains. as when it is asked, whether there was noise in the street last night; and if there were not, the patient is reported, without more ado, to have had a good night. patients are completely taken aback by these kinds of leading questions, and give only the exact amount of information asked for, even when they know it to be completely misleading. the shyness of patients is seldom allowed for. how few there are who, by five or six pointed questions, can elicit the whole case and get accurately to know and to be able to report _where_ the patient is. [sidenote: means of obtaining inaccurate information.] i knew a very clever physician, of large dispensary and hospital practice, who invariably began his examination of each patient with "put your finger where you be bad." that man would never waste his time with collecting inaccurate information from nurse or patient. leading questions always collect inaccurate information. at a recent celebrated trial, the following leading question was put successively to nine distinguished medical men. "can you attribute these symptoms to anything else but poison?" and out of the nine, eight answered "no!" without any qualification whatever. it appeared, upon cross-examination:-- . that none of them had ever seen a case of the kind of poisoning supposed. . that none of them had ever seen a case of the kind of disease to which the death, if not to poison, was attributable. . that none of them were even aware of the main fact of the disease and condition to which the death was attributable. surely nothing stronger can be adduced to prove what use leading questions are of, and what they lead to. i had rather not say how many instances i have known, where, owing to this system of leading questions, the patient has died, and the attendants have been actually unaware of the principal feature of the case. [sidenote: as to food patient takes or does not take.] it is useless to go through all the particulars, besides sleep, in which people have a peculiar talent for gleaning inaccurate information. as to food, for instance, i often think that most common question, how is your appetite? can only be put because the questioner believes the questioned has really nothing the matter with him, which is very often the case. but where there is, the remark holds good which has been made about sleep. the _same_ answer will often be made as regards a patient who cannot take two ounces of solid food per diem, and a patient who does not enjoy five meals a day as much as usual. again, the question, how is your appetite? is often put when how is your digestion? is the question meant. no doubt the two things depend on one another. but they are quite different. many a patient can eat, if you can only "tempt his appetite." the fault lies in your not having got him the thing that he fancies. but many another patient does not care between grapes and turnips,--everything is equally distasteful to him. he would try to eat anything which would do him good; but everything "makes him worse." the fault here generally lies in the cooking. it is not his "appetite" which requires "tempting," it is his digestion which requires sparing. and good sick cookery will save the digestion half its work. there may be four different causes, any one of which will produce the same result, viz., the patient slowly starving to death from want of nutrition: . defect in cooking; . defect in choice of diet; . defect in choice of hours for taking diet; . defect of appetite in patient. yet all these are generally comprehended in the one sweeping assertion that the patient has "no appetite." surely many lives might be saved by drawing a closer distinction; for the remedies are as diverse as the causes. the remedy for the first is, to cook better; for the second, to choose other articles of diet; for the third, to watch for the hours when the patient is in want of food; for the fourth, to show him what he likes, and sometimes unexpectedly. but no one of these remedies will do for any other of the defects not corresponding with it. i cannot too often repeat that patients are generally either too languid to observe these things, or too shy to speak about them; nor is it well that they should be made to observe them, it fixes their attention upon themselves. again, i say, what _is_ the nurse or friend there for except to take note of these things, instead of the patient doing so?[ ] [sidenote: as to diarrhoea.] again, the question is sometimes put, is there diarrhoea? and the answer will be the same, whether it is just merging into cholera, whether it is a trifling degree brought on by some trifling indiscretion, which will cease the moment the cause is removed, or whether there is no diarrhoea at all, but simply relaxed bowels. it is useless to multiply instances of this kind. as long as observation is so little cultivated as it is now, i do believe that it is better for the physician _not_ to see the friends of the patient at all. they will oftener mislead him than not. and as often by making the patient out worse as better than he really is. in the case of infants, _everything_ must depend upon the accurate observation of the nurse or mother who has to report. and how seldom is this condition of accuracy fulfilled. [sidenote: means of cultivating sound and ready observation.] a celebrated man, though celebrated only for foolish things, has told us that one of his main objects in the education of his son, was to give him a ready habit of accurate observation, a certainty of perception, and that for this purpose one of his means was a month's course as follows:--he took the boy rapidly past a toy-shop; the father and son then described to each other as many of the objects as they could, which they had seen in passing the windows, noting them down with pencil and paper, and returning afterwards to verify their own accuracy. the boy always succeeded best, e.g., if the father described objects, the boy did , and scarcely ever made a mistake. i have often thought how wise a piece of education this would be for much higher objects; and in our calling of nurses the thing itself is essential. for it may safely be said, not that the habit of ready and correct observation will by itself make us useful nurses, but that without it we shall be useless with all our devotion. i have known a nurse in charge of a set of wards who not only carried in her head all the little varieties in the diets which each patient was allowed to fix for himself, but also exactly what each patient had taken during each day. i have known another nurse in charge of one single patient, who took away his meals day after day all but untouched, and never knew it. if you find it helps you to note down such things on a bit of paper, in pencil, by all means do so. i think it more often lames than strengthens the memory and observation. but if you cannot get the habit of observation one way or other, you had better give up the being a nurse, for it is not your calling, however kind and anxious you may be. surely you can learn at least to judge with the eye how much an oz. of solid food is, how much an oz. of liquid. you will find this helps your observation and memory very much, you will then say to yourself "a. took about an oz. of his meat to day;" "b. took three times in hours about / pint of beef tea;" instead of saying "b. has taken nothing all day," or "i gave a. his dinner as usual." [sidenote: sound and ready observation essential in a nurse.] i have known several of our real old-fashioned hospital "sisters," who could, as accurately as a measuring glass, measure out all their patients' wine and medicine by the eye, and never be wrong. i do not recommend this, one must be very sure of one's self to do it. i only mention it, because if a nurse can by practice measure medicine by the eye, surely she is no nurse who cannot measure by the eye about how much food (in oz.) her patient has taken.[ ] in hospitals those who cut up the diets give with quite sufficient accuracy, to each patient, his oz. or his oz. of meat without weighing. yet a nurse will often have patients loathing all food and incapable of any will to get well, who just tumble over the contents of the plate or dip the spoon in the cup to deceive the nurse, and she will take it away without ever seeing that there is just the same quantity of food as when she brought it, and she will tell the doctor, too, that the patient has eaten all his diets as usual, when all she ought to have meant is that she has taken away his diets as usual. now what kind of a nurse is this? [sidenote: difference of excitable and _accumulative_ temperaments.] i would call attention to something else, in which nurses frequently fail in observation. there is a well-marked distinction between the excitable and what i will call the _accumulative_ temperament in patients. one will blaze up at once, under any shock or anxiety, and sleep very comfortably after it; another will seem quite calm and even torpid, under the same shock, and people say, "he hardly felt it at all," yet you will find him some time after slowly sinking. the same remark applies to the action of narcotics, of aperients, which, in the one, take effect directly, in the other not perhaps for twenty-four hours. a journey, a visit, an unwonted exertion, will affect the one immediately, but he recovers after it; the other bears it very well at the time, apparently, and dies or is prostrated for life by it. people often say how difficult the excitable temperament is to manage. i say how difficult is the _accumulative_ temperament. with the first you have an out-break which you could anticipate, and it is all over. with the second you never know where you are--you never know when the consequences are over. and it requires your closest observation to know what _are_ the consequences of what--for the consequent by no means follows immediately upon the antecedent--and coarse observation is utterly at fault. [sidenote: superstition the fruit of bad observation.] almost all superstitions are owing to bad observation, to the _post hoc, ergo propter hoc_; and bad observers are almost all superstitious. farmers used to attribute disease among cattle to witchcraft; weddings have been attributed to seeing one magpie, deaths to seeing three; and i have heard the most highly educated now-a-days draw consequences for the sick closely resembling these. [sidenote: physiognomy of disease little shown by the face.] another remark: although there is unquestionably a physiognomy of disease as well as of health; of all parts of the body, the face is perhaps the one which tells the least to the common observer or the casual visitor. because, of all parts of the body, it is the one most exposed to other influences, besides health. and people never, or scarcely ever, observe enough to know how to distinguish between the effect of exposure, of robust health, of a tender skin, of a tendency to congestion, of suffusion, flushing, or many other things. again, the face is often the last to shew emaciation. i should say that the hand was a much surer test than the face, both as to flesh, colour, circulation, &c., &c. it is true that there are _some_ diseases which are only betrayed at all by something in the face, e.g., the eye or the tongue, as great irritability of brain by the appearance of the pupil of the eye. but we are talking of casual, not minute, observation. and few minute observers will hesitate to say that far more untruth than truth is conveyed by the oft repeated words, he _looks_ well, or ill, or better or worse. wonderful is the way in which people will go upon the slightest observation, or often upon no observation at all, or upon some _saw_ which the world's experience, if it had any, would have pronounced utterly false long ago. i have known patients dying of sheer pain, exhaustion, and want of sleep, from one of the most lingering and painful diseases known, preserve, till within a few days of death, not only the healthy colour of the cheek, but the mottled appearance of a robust child. and scores of times have i heard these unfortunate creatures assailed with, "i am glad to see you looking so well." "i see no reason why you should not live till ninety years of age." "why don't you take a little more exercise and amusement?" with all the other commonplaces with which we are so familiar. there is, unquestionably, a physiognomy of disease. let the nurse learn it. the experienced nurse can always tell that a person has taken a narcotic the night before by the patchiness of the colour about the face, when the re-action of depression has set in; that very colour which the inexperienced will point to as a proof of health. there is, again, a faintness, which does not betray itself by the colour at all, or in which the patient becomes brown instead of white. there is a faintness of another kind which, it is true, can always be seen by the paleness. but the nurse seldom distinguishes. she will talk to the patient who is too faint to move, without the least scruple, unless he is pale and unless, luckily for him, the muscles of the throat are affected and he loses his voice. yet these two faintnesses are perfectly distinguishable, by the mere countenance of the patient. [sidenote: peculiarities of patients.] again, the nurse must distinguish between the idiosyncracies of patients. one likes to suffer out all his suffering alone, to be as little looked after as possible. another likes to be perpetually made much of and pitied, and to have some one always by him. both these peculiarities might be observed and indulged much more than they are. for quite as often does it happen that a busy attendance is forced upon the first patient, who wishes for nothing but to be "let alone," as that the second is left to think himself neglected. [sidenote: nurse must observe for herself increase of patient's weakness, patient will not tell her.] again, i think that few things press so heavily on one suffering from long and incurable illness, as the necessity of recording in words from time to time, for the information of the nurse, who will not otherwise see, that he cannot do this or that, which he could do a month or a year ago. what is a nurse there for if she cannot observe these things for herself? yet i have known--and known too among those--and _chiefly_ among those--whom money and position put in possession of everything which money and position could give--i have known, i say, more accidents, (fatal, slowly or rapidly,) arising from this want of observation among nurses than from almost anything else. because a patient could get out of a warm-bath alone a month ago--because a patient could walk as far as his bell a week ago, the nurse concludes that he can do so now. she has never observed the change; and the patient is lost from being left in a helpless state of exhaustion, till some one accidentally comes in. and this not from any unexpected apoplectic, paralytic, or fainting fit (though even these could be expected far more, at least, than they are now, if we did but _observe_). no, from the expected, or to be expected, inevitable, visible, calculable, uninterrupted increase of weakness, which none need fail to observe. [sidenote: accidents arising from the nurse's want of observation.] again, a patient not usually confined to bed, is compelled by an attack of diarrhoea, vomiting, or other accident, to keep his bed for a few days; he gets up for the first time, and the nurse lets him go into another room, without coming in, a few minutes afterwards, to look after him. it never occurs to her that he is quite certain to be faint, or cold, or to want something. she says, as her excuse, oh, he does not like to be fidgetted after. yes, he said so some weeks ago; but he never said he did not like to be "fidgetted after," when he is in the state he is in now; and if he did, you ought to make some excuse to go in to him. more patients have been lost in this way than is at all generally known, viz., from relapses brought on by being left for an hour or two faint, or cold, or hungry, after getting up for the first time. [sidenote: is the faculty of observing on the decline.] yet it appears that scarcely any improvement in the faculty of observing is being made. vast has been the increase of knowledge in pathology--that science which teaches us the final change produced by disease on the human frame--scarce any in the art of observing the signs of the change while in progress. or, rather, is it not to be feared that observation, as an essential part of medicine, has been declining? which of us has not heard fifty times, from one or another, a nurse, or a friend of the sick, aye, and a medical friend too, the following remark:--"so a is worse, or b is dead. i saw him the day before; i thought him so much better; there certainly was no appearance from which one could have expected so sudden (?) a change." i have never heard any one say, though one would think it the more natural thing, "there _must_ have been _some_ appearance, which i should have seen if i had but looked; let me try and remember what there was, that i may observe another time." no, this is not what people say. they boldly assert that there was nothing to observe, not that their observation was at fault. let people who have to observe sickness and death look back and try to register in their observation the appearances which have preceded relapse, attack, or death, and not assert that there were none, or that there were not the _right_ ones.[ ] [sidenote: observation of general conditions.] a want of the habit of observing conditions and an inveterate habit of taking averages are each of them often equally misleading. men whose profession like that of medical men leads them to observe only, or chiefly, palpable and permanent organic changes are often just as wrong in their opinion of the result as those who do not observe at all. for instance, there is a broken leg; the surgeon has only to look at it once to know; it will not be different if he sees it in the morning to what it would have been had he seen it in the evening. and in whatever conditions the patient is, or is likely to be, there will still be the broken leg, until it is set. the same with many organic diseases. an experienced physician has but to feel the pulse once, and he knows that there is aneurism which will kill some time or other. but with the great majority of cases, there is nothing of the kind; and the power of forming any correct opinion as to the result must entirely depend upon an enquiry into all the conditions in which the patient lives. in a complicated state of society in large towns, death, as every one of great experience knows, is far less often produced by any one organic disease than by some illness, after many other diseases, producing just the sum of exhaustion necessary for death. there is nothing so absurd, nothing so misleading as the verdict one so often hears: so-and-so has no organic disease,--there is no reason why he should not live to extreme old age; sometimes the clause is added, sometimes not: provided he has quiet, good food, good air, &c., &c., &c.; the verdict is repeated by ignorant people _without_ the latter clause; or there is no possibility of the conditions of the latter clause being obtained; and this, the _only_ essential part of the whole, is made of no effect. i have heard a physician, deservedly eminent, assure the friends of a patient of his recovery. why? because he had now prescribed a course, every detail of which the patient had followed for years. and because he had forbidden a course which the patient could not by any possibility alter.[ ] undoubtedly a person of no scientific knowledge whatever but of observation and experience in these kinds of conditions, will be able to arrive at a much truer guess as to the probable duration of life of members of a family or inmates of a house, than the most scientific physician to whom the same persons are brought to have their pulse felt; no enquiry being made into their conditions. in life insurance and such like societies, were they instead of having the persons examined by a medical man, to have the houses, conditions, ways of life, of these persons examined, at how much truer results would they arrive! w. smith appears a fine hale man, but it might be known that the next cholera epidemic he runs a bad chance. mr. and mrs. j. are a strong healthy couple, but it might be known that they live in such a house, in such a part of london, so near the river that they will kill four-fifths of their children; which of the children will be the ones to survive might also be known. [sidenote: "average rate of mortality" tells us only that so many per cent. will die. observation must tell us _which_ in the hundred they will be who will die.] averages again seduce us away from minute observation. "average mortalities" merely tell that so many per cent. die in this town and so many in that, per annum. but whether a or b will be among these, the "average rate" of course does not tell. we know, say, that from to per , will die in london next year. but minute enquiries into conditions enable us to know that in such a district, nay, in such a street,--or even on one side of that street, in such a particular house, or even on one floor of that particular house, will be the excess of mortality, that is, the person will die who ought not to have died before old age. now, would it not very materially alter the opinion of whoever were endeavouring to form one, if he knew that from that floor, of that house, of that street the man came? much more precise might be our observations even than this and much more correct our conclusions. it is well known that the same names may be seen constantly recurring on workhouse books for generations. that is, the persons were born and brought up, and will be born and brought up, generation after generation, in the conditions which make paupers. death and disease are like the workhouse, they take from the same family, the same house, or in other words the same conditions. why will we not observe what they are? the close observer may safely predict that such a family, whether its members marry or not, will become extinct; that such another will degenerate morally and physically. but who learns the lesson? on the contrary, it may be well known that the children die in such a house at the rate of out of ; one would think that nothing more need be said; for how could providence speak more distinctly? yet nobody listens, the family goes on living there till it dies out, and then some other family takes it. neither would they listen "if one rose from the dead." [sidenote: what observation is for.] in dwelling upon the vital importance of _sound_ observation, it must never be lost sight of what observation is for. it is not for the sake of piling up miscellaneous information or curious facts, but for the sake of saving life and increasing health and comfort. the caution may seem useless, but it is quite surprising how many men (some women do it too), practically behave as if the scientific end were the only one in view, or as if the sick body were but a reservoir for stowing medicines into, and the surgical disease only a curious case the sufferer has made for the attendant's special information. this is really no exaggeration. you think, if you suspected your patient was being poisoned, say, by a copper kettle, you would instantly, as you ought, cut off all possible connection between him and the suspected source of injury, without regard to the fact that a curious mine of observation is thereby lost. but it is not everybody who does so, and it has actually been made a question of medical ethics, what should the medical man do if he suspected poisoning? the answer seems a very simple one,--insist on a confidential nurse being placed with the patient, or give up the case. [sidenote: what a confidential nurse should be.] and remember every nurse should be one who is to be depended upon, in other words, capable of being a "confidential" nurse. she does not know how soon she may find herself placed in such a situation; she must be no gossip, no vain talker; she should never answer questions about her sick except to those who have a right to ask them; she must, i need not say, be strictly sober and honest; but more than this, she must be a religious and devoted woman; she must have a respect for her own calling, because god's precious gift of life is often literally placed in her hands; she must be a sound, and close, and quick observer; and she must be a woman of delicate and decent feeling. [sidenote: observation is for practical purposes.] to return to the question of what observation is for:--it would really seem as if some had considered it as its own end, as if detection, not cure, was their business; nay more, in a recent celebrated trial, three medical men, according to their own account, suspected poison, prescribed for dysentery, and left the patient to the poisoner. this is an extreme case. but in a small way, the same manner of acting falls under the cognizance of us all. how often the attendants of a case have stated that they knew perfectly well that the patient could not get well in such an air, in such a room, or under such circumstances, yet have gone on dosing him with medicine, and making no effort to remove the poison from him, or him from the poison which they knew was killing him; nay, more, have sometimes not so much as mentioned their conviction in the right quarter--that is, to the only person who could act in the matter. conclusion. [sidenote: sanitary nursing as essential in surgical as in medical cases, but not to supersede surgical nursing.] the whole of the preceding remarks apply even more to children and to puerperal women than to patients in general. they also apply to the nursing of surgical, quite as much as to that of medical cases. indeed, if it be possible, cases of external injury require such care even more than sick. in surgical wards, one duty of every nurse certainly is _prevention_. fever, or hospital gangrene, or pyæmia, or purulent discharge of some kind may else supervene. has she a case of compound fracture, of amputation, or of erysipelas, it may depend very much on how she looks upon the things enumerated in these notes, whether one or other of these hospital diseases attacks her patient or not. if she allows her ward to become filled with the peculiar close foetid smell, so apt to be produced among surgical cases, especially where there is great suppuration and discharge, she may see a vigorous patient in the prime of life gradually sink and die where, according to all human probability, he ought to have recovered. the surgical nurse must be ever on the watch, ever on her guard, against want of cleanliness, foul air, want of light, and of warmth. nevertheless let no one think that because _sanitary_ nursing is the subject of these notes, therefore, what may be called the handicraft of nursing is to be undervalued. a patient may be left to bleed to death in a sanitary palace. another who cannot move himself may die of bed-sores, because the nurse does not know how to change and clean him, while he has every requisite of air, light, and quiet. but nursing, as a handicraft, has not been treated of here for three reasons: . that these notes do not pretend to be a manual for nursing, any more than for cooking for the sick; . that the writer, who has herself seen more of what may be called surgical nursing, i.e., practical manual nursing, than, perhaps, any one in europe, honestly believes that it is impossible to learn it from any book, and that it can only be thoroughly learnt in the wards of a hospital; and she also honestly believes that the perfection of surgical nursing may be seen practised by the old-fashioned "sister" of a london hospital, as it can be seen nowhere else in europe. . while thousands die of foul air, &c., who have this surgical nursing to perfection, the converse is comparatively rare. [sidenote: children: their greater susceptibility to the same things.] to revert to children. they are much more susceptible than grown people to all noxious influences. they are affected by the same things, but much more quickly and seriously, viz., by want of fresh air, of proper warmth, want of cleanliness in house, clothes, bedding, or body, by startling noises, improper food, or want of punctuality, by dulness and by want of light, by too much or too little covering in bed, or when up, by want of the spirit of management generally in those in charge of them. one can, therefore, only press the importance, as being yet greater in the case of children, greatest in the case of sick children, of attending to these things. that which, however, above all, is known to injure children seriously is foul air, and most seriously at night. keeping the rooms where they sleep tight shut up, is destruction to them. and, if the child's breathing be disordered by disease, a few hours only of such foul air may endanger its life, even where no inconvenience is felt by grown-up persons in the same room. the following passages, taken out of an excellent "lecture on sudden death in infancy and childhood," just published, show the vital importance of careful nursing of children. "in the great majority of instances, when death suddenly befalls the infant or young child, it is an _accident_; it is not a necessary, inevitable result of any disease from which it is suffering." it may be here added, that it would be very desirable to know how often death is, with adults, "not a necessary, inevitable result of any disease." omit the word "sudden;" (for _sudden_ death is comparatively rare in middle age;) and the sentence is almost equally true for all ages. the following causes of "accidental" death in sick children are enumerated:--"sudden noises, which startle--a rapid change of temperature, which chills the surface, though only for a moment--a rude awakening from sleep--or even an over-hasty, or an over-full meal"--"any sudden impression on the nervous system--any hasty alteration of posture--in short, any cause whatever by which the respiratory process may be disturbed." it may again be added, that, with very weak adult patients, these causes are also (not often "suddenly fatal," it is true, but) very much oftener than is at all generally known, irreparable in their consequences. both for children and for adults, both for sick and for well (although more certainly in the case of sick children than in any others), i would here again repeat, the most frequent and most fatal cause of all is sleeping, for even a few hours, much more for weeks and months, in foul air, a condition which, more than any other condition, disturbs the respiratory process, and tends to produce "accidental" death in disease. i need hardly here repeat the warning against any confusion of ideas between cold and fresh air. you may chill a patient fatally without giving him fresh air at all. and you can quite well, nay, much better, give him fresh air without chilling him. this is the test of a good nurse. in cases of long recurring faintnesses from disease, for instance, especially disease which affects the organs of breathing, fresh air to the lungs, warmth to the surface, and often (as soon as the patient can swallow) hot drink, these are the right remedies and the only ones. yet, oftener than not, you see the nurse or mother just reversing this; shutting up every cranny through which fresh air can enter, and leaving the body cold, or perhaps throwing a greater weight of clothes upon it, when already it is generating too little heat. "breathing carefully, anxiously, as though respiration were a function which required all the attention for its performance," is cited as a not unusual state in children, and as one calling for care in all the things enumerated above. that breathing becomes an almost voluntary act, even in grown up patients who are very weak, must often have been remarked. "disease having interfered with the perfect accomplishment of the respiratory function, some sudden demand for its complete exercise, issues in the sudden standstill of the whole machinery," is given as one process:--"life goes out for want of nervous power to keep the vital functions in activity," is given as another, by which "accidental" death is most often brought to pass in infancy. also in middle age, both these processes may be seen ending in death, although generally not suddenly. and i have seen, even in middle age, the "_sudden_ stand-still" here mentioned, and from the same causes. [sidenote: summary.] to sum up:--the answer to two of the commonest objections urged, one by women themselves, the other by men, against the desirableness of sanitary knowledge for women, _plus_ a caution, comprises the whole argument for the art of nursing. [sidenote: reckless amateur physicking by women. real knowledge of the laws of health alone can check this.] ( .) it is often said by men, that it is unwise to teach women anything about these laws of health, because they will take to physicking,--that there is a great deal too much of amateur physicking as it is, which is indeed true. one eminent physician told me that he had known more calomel given, both at a pinch and for a continuance, by mothers, governesses, and nurses, to children than he had ever heard of a physician prescribing in all his experience. another says, that women's only idea in medicine is calomel and aperients. this is undeniably too often the case. there is nothing ever seen in any professional practice like the reckless physicking by amateur females.[ ] but this is just what the really experienced and observing nurse does _not_ do; she neither physics herself nor others. and to cultivate in things pertaining to health observation and experience in women who are mothers, governesses or nurses, is just the way to do away with amateur physicking, and if the doctors did but know it, to make the nurses obedient to them,--helps to them instead of hindrances. such education in women would indeed diminish the doctor's work--but no one really believes that doctors wish that there should be more illness, in order to have more work. [sidenote: what pathology teaches. what observation alone teaches. what medicine does. what nature alone does.] ( .) it is often said by women, that they cannot know anything of the laws of health, or what to do to preserve their children's health, because they can know nothing of "pathology," or cannot "dissect,"--a confusion of ideas which it is hard to attempt to disentangle. pathology teaches the harm that disease has done. but it teaches nothing more. we know nothing of the principle of health, the positive of which pathology is the negative, except from observation and experience. and nothing but observation and experience will teach us the ways to maintain or to bring back the state of health. it is often thought that medicine is the curative process. it is no such thing; medicine is the surgery of functions, as surgery proper is that of limbs and organs. neither can do anything but remove obstructions; neither can cure; nature alone cures. surgery removes the bullet out of the limb, which is an obstruction to cure, but nature heals the wound. so it is with medicine; the function of an organ becomes obstructed; medicine, so far as we know, assists nature to remove the obstruction, but does nothing more. and what nursing has to do in either case, is to put the patient in the best condition for nature to act upon him. generally, just the contrary is done. you think fresh air, and quiet and cleanliness extravagant, perhaps dangerous, luxuries, which should be given to the patient only when quite convenient, and medicine the _sine quâ non_, the panacea. if i have succeeded in any measure in dispelling this illusion, and in showing what true nursing is, and what it is not, my object will have been answered. now for the caution:-- ( .) it seems a commonly received idea among men and even among women themselves that it requires nothing but a disappointment in love, the want of an object, a general disgust, or incapacity for other things, to turn a woman into a good nurse. this reminds one of the parish where a stupid old man was set to be schoolmaster because he was "past keeping the pigs." apply the above receipt for making a good nurse to making a good servant. and the receipt will be found to fail. yet popular novelists of recent days have invented ladies disappointed in love or fresh out of the drawing-room turning into the war-hospitals to find their wounded lovers, and when found, forthwith abandoning their sick-ward for their lover, as might be expected. yet in the estimation of the authors, these ladies were none the worse for that, but on the contrary were heroines of nursing. what cruel mistakes are sometimes made by benevolent men and women in matters of business about which they can know nothing and think they know a great deal. the everyday management of a large ward, let alone of a hospital--the knowing what are the laws of life and death for men, and what the laws of health for wards--(and wards are healthy or unhealthy, mainly according to the knowledge or ignorance of the nurse)--are not these matters of sufficient importance and difficulty to require learning by experience and careful inquiry, just as much as any other art? they do not come by inspiration to the lady disappointed in love, nor to the poor workhouse drudge hard up for a livelihood. and terrible is the injury which has followed to the sick from such wild notions! in this respect (and why is it so?), in roman catholic countries, both writers and workers are, in theory at least, far before ours. they would never think of such a beginning for a good working superior or sister of charity. and many a superior has refused to admit a _postulant_ who appeared to have no better "vocation" or reasons for offering herself than these. it is true _we_ make "no vows." but is a "vow" necessary to convince us that the true spirit for learning any art, most especially an art of charity, aright, is not a disgust to everything or something else? do we really place the love of our kind (and of nursing, as one branch of it,) so low as this? what would the mère angélique of port royal, what would our own mrs. fry have said to this? note.--i would earnestly ask my sisters to keep clear of both the jargons now current everywhere (for they _are_ equally jargons); of the jargon, namely, about the "rights" of women, which urges women to do all that men do, including the medical and other professions, merely because men do it, and without regard to whether this _is_ the best that women can do; and of the jargon which urges women to do nothing that men do, merely because they are women, and should be "recalled to a sense of their duty as women," and because "this is women's work," and "that is men's," and "these are things which women should not do," which is all assertion and nothing more. surely woman should bring the best she has, _whatever_ that is, to the work of god's world, without attending to either of these cries. for what are they, both of them, the one _just_ as much as the other, but listening to the "what people will say," to opinion, to the "voices from without?" and as a wise man has said, no one has ever done anything great or useful by listening to the voices from without. you do not want the effect of your good things to be, "how wonderful for a _woman!_" nor would you be deterred from good things, by hearing it said, "yes, but she ought not to have done this, because it is not suitable for a woman." but you want to do the thing that is good, whether it is "suitable for a woman" or not. it does not make a thing good, that it is remarkable that a woman should have been able to do it. neither does it make a thing bad, which would have been good had a man done it, that it has been done by a woman. oh, leave these jargons, and go your way straight to god's work, in simplicity and singleness of heart. appendix. [transcriber's note: the tables below have been rotated through for easier display.] table a. great britain. ages. | nurse | nurse | nurses. | (not domestic | (domestic | | servant) | servant) | -------------------+---------------+-----------+ all ages | , | , | under years. | ... | ... | - | ... | | - | ... | , | - | ... | , | - | | , | - | | , | - | , | , | - | , | , | - | , | , | - | , | , | - | , | , | - | , | | - | , | | - | , | | - | , | | - | | | - | | | and upwards | | | -------------------+---------------+-----------+ table b. aged years of age, and upwards. |nurse |nurse | |(not domestic |(domestic | |servant) |servant) | -----------------------------------------------+--------------+-----------+ great britain and islands in the british seas. | , | , | england and wales. | , | , | scotland. | , | , | islands in the british seas. | | | st division. london. | , | , | nd division. south eastern. | , | , | rd division. south midland. | , | , | th division. eastern counties. | , | | th division. south western counties. | , | , | th division. west midland counties. | , | , | th division. north midland counties. | , | | th division. north western counties. | | , | th division. yorkshire. | , | , | th division. northern counties. | | | th division. monmouth and wales. | | | -----------------------------------------------+--------------+-----------+ note as to the number of women employed as nurses in great britain. , were returned, at the census of , as nurses by profession, , nurses in domestic service,[ ] and , midwives. the numbers of different ages are shown in table a, and in table b their distribution over great britain. to increase the efficiency of this class, and to make as many of them as possible the disciples of the true doctrines of health, would be a great national work. for there the material exists, and will be used for nursing, whether the real "conclusion of the matter" be to nurse or to poison the sick. a man, who stands perhaps at the head of our medical profession, once said to me, i send a nurse into a private family to nurse the sick, but i know that it is only to do them harm. now a nurse means any person in charge of the personal health of another. and, in the preceding notes, the term _nurse_ is used indiscriminately for amateur and professional nurses. for, besides nurses of the sick and nurses of children, the numbers of whom are here given, there are friends or relations who take temporary charge of a sick person, there are mothers of families. it appears as if these unprofessional nurses were just as much in want of knowledge of the laws of health as professional ones. then there are the school-mistresses of all national and other schools throughout the kingdom. how many of children's epidemics originate in these! then the proportion of girls in these schools, who become mothers or members among the , nurses recorded above, or schoolmistresses in their turn. if the laws of health, as far as regards fresh air, cleanliness, light, &c., were taught to these, would this not prevent some children being killed, some evil being perpetuated? on women we must depend, first and last, for personal and household hygiene--for preventing the race from degenerating in as far as these things are concerned. would not the true way of infusing the art of preserving its own health into the human race be to teach the female part of it in schools and hospitals, both by practical teaching and by simple experiments, in as far as these illustrate what may be called the theory of it? footnotes [ ] [sidenote: curious deductions from an excessive death rate.] upon this fact the most wonderful deductions have been strung. for a long time an announcement something like the following has been going the round of the papers:--"more than , children die every year in london under years of age; therefore we want a children's hospital." this spring there was a prospectus issued, and divers other means taken to this effect:--"there is a great want of sanitary knowledge in women; therefore we want a women's hospital." now, both the above facts are too sadly true. but what is the deduction? the causes of the enormous child mortality are perfectly well known; they are chiefly want of cleanliness, want of ventilation, want of white-washing; in one word, defective _household_ hygiene. the remedies are just as well known; and among them is certainly not the establishment of a child's hospital. this may be a want; just as there may be a want of hospital room for adults. but the registrar-general would certainly never think of giving us as a cause for the high rate of child mortality in (say) liverpool that there was not sufficient hospital room for children; nor would he urge upon us, as a remedy, to found a hospital for them. again, women, and the best women, are wofully deficient in sanitary knowledge; although it is to women that we must look, first and last, for its application, as far as _household_ hygiene is concerned. but who would ever think of citing the institution of a women's hospital as the way to cure this want? we have it, indeed, upon very high authority that there is some fear lest hospitals, as they have been _hitherto_, may not have generally increased, rather than diminished, the rate of mortality--especially of child mortality. [ ] [sidenote: why are uninhabited rooms shut up?] the common idea as to uninhabited rooms is, that they may safely be left with doors, windows, shutters, and chimney board, all closed--hermetically sealed if possible--to keep out the dust, it is said; and that no harm will happen if the room is but opened a short hour before the inmates are put in. i have often been asked the question for uninhabited rooms--but when ought the windows to be opened? the answer is--when ought they to be shut? [ ] it is very desirable that the windows in a sick room should be such as that the patient shall, if he can move about, be able to open and shut them easily himself. in fact the sick room is very seldom kept aired if this is not the case--so very few people have any perception of what is a healthy atmosphere for the sick. the sick man often says, "this room where i spend hours out of the is fresher than the other where i only spend . because here i can manage the windows myself." and [transcriber's note: word, possibly "it" missing in original.] is true. [ ] [sidenote: an air-test of essential consequence.] dr. angus smith's air test, if it could be made of simpler application, would be invaluable to use in every sleeping and sick room. just as without the use of a thermometer no nurse should ever put a patient into a bath, so should no nurse, or mother, or superintendent be without the air test in any ward, nursery, or sleeping-room. if the main function of a nurse is to maintain the air within the room as fresh as the air without, without lowering the temperature, then she should always be provided with a thermometer which indicates the temperature, with an air test which indicates the organic matter of the air. but to be used, the latter must be made as simple a little instrument as the former, and both should be self-registering. the senses of nurses and mothers become so dulled to foul air that they are perfectly unconscious of what an atmosphere they have let their children, patients, or charges, sleep in. but if the tell-tale air-test were to exhibit in the morning, both to nurses and patients and to the superior officer going round, what the atmosphere has been during the night, i question if any greater security could be afforded against a recurrence of the misdemeanour. and oh; the crowded national school! where so many children's epidemics have their origin, what a tale its air-test would tell! we should have parents saying, and saying rightly, "i will not send my child to that school, the air-test stands at 'horrid.'" and the dormitories of our great boarding schools! scarlet fever would be no more ascribed to contagion, but to its right cause, the air-test standing at "foul." we should hear no longer of "mysterious dispensations," and of "plague and pestilence," being "in god's hands," when, so far as we know, he has put them into our own. the little air-test would both betray the cause of these "mysterious pestilences," and call upon us to remedy it. [ ] with private sick, i think, but certainly with hospital sick, the nurse should never be satisfied as to the freshness of their atmosphere, unless she can feel the air gently moving over her face, when still. but it is often observed that nurses who make the greatest outcry against open windows are those who take the least pains to prevent dangerous draughts. the door of the patients' room or ward _must_ sometimes stand open to allow of persons passing in and out, or heavy things being carried in and out. the careful nurse will keep the door shut while she shuts the windows, and then, and not before, set the door open, so that a patient may not be left sitting up in bed, perhaps in a profuse perspiration, directly in the draught between the open door and window. neither, of course, should a patient, while being washed or in any way exposed, remain in the draught of an open window or door. [ ] [sidenote: don't make your sick-room into a sewer.] but never, never should the possession of this indispensable lid confirm you in the abominable practice of letting the chamber utensil remain in a patient's room unemptied, except once in the hours, i.e., when the bed is made. yes, impossible as it may appear, i have known the best and most attentive nurses guilty of this; aye, and have known, too, a patient afflicted with severe diarrhoea for ten days, and the nurse (a very good one) not know of it, because the chamber utensil (one with a lid) was emptied only once in the hours, and that by the housemaid who came in and made the patient's bed every evening. as well might you have a sewer under the room, or think that in a water closet the plug need be pulled up but once a day. also take care that your _lid_, as well as your utensil, be always thoroughly rinsed. if a nurse declines to do these kinds of things for her patient, "because it is not her business," i should say that nursing was not her calling. i have seen surgical "sisters," women whose hands were worth to them two or three guineas a-week, down upon their knees scouring a room or hut, because they thought it otherwise not fit for their patients to go into. i am far from wishing nurses to scour. it is a waste of power. but i do say that these women had the true nurse-calling--the good of their sick first, and second only the consideration what it was their "place" to do--and that women who wait for the housemaid to do this, or for the charwoman to do that, when their patients are suffering, have not the _making_ of a nurse in them. [ ] [sidenote: health of carriages.] the health of carriages, especially close carriages, is not of sufficient universal importance to mention here, otherwise than cursorily. children, who are always the most delicate test of sanitary conditions, generally cannot enter a close carriage without being sick--and very lucky for them that it is so. a close carriage, with the horse-hair cushions and linings always saturated with organic matter, if to this be added the windows up, is one of the most unhealthy of human receptacles. the idea of taking an _airing_ in it is something preposterous. dr. angus smith has shown that a crowded railway carriage, which goes at the rate of miles an hour, is as unwholesome as the strong smell of a sewer, or as a back yard in one of the most unhealthy courts off one of the most unhealthy streets in manchester. [ ] god lays down certain physical laws. upon his carrying out such laws depends our responsibility (that much abused word), for how could we have any responsibility for actions, the results of which we could not foresee--which would be the case if the carrying out of his laws were _not_ certain. yet we seem to be continually expecting that he will work a miracle--i.e. break his own laws expressly to relieve us of responsibility. [ ] [sidenote: servants' rooms.] i must say a word about servants' bed-rooms. from the way they are built, but oftener from the way they are kept, and from no intelligent inspection whatever being exercised over them, they are almost invariably dens of foul air, and the "servants' health" suffers in an "unaccountable" (?) way, even in the country. for i am by no means speaking only of london houses, where too often servants are put to live under the ground and over the roof. but in a country "_mansion_," which was really a "mansion," (not after the fashion of advertisements), i have known three maids who slept in the same room ill of scarlet fever. "how catching it is," was of course the remark. one look at the room, one smell of the room, was quite enough. it was no longer "unaccountable." the room was not a small one; it was up stairs, and it had two large windows--but nearly every one of the neglects enumerated above was there. [ ] [sidenote: diseases are not individuals arranged in classes, like cats and dogs, but conditions growing out of one another.] is it not living in a continual mistake to look upon diseases, as we do now, as separate entities, which _must_ exist, like cats and dogs? instead of looking upon them as conditions, like a dirty and a clean condition, and just as much under our own control; or rather as the reactions of kindly nature, against the conditions in which we have placed ourselves. i was brought up, both by scientific men and ignorant women, distinctly to believe that small-pox, for instance, was a thing of which there was once a first specimen in the world, which went on propagating itself, in a perpetual chain of descent, just as much as that there was a first dog, (or a first pair of dogs), and that small-pox would not begin itself any more than a new dog would begin without there having been a parent dog. since then i have seen with my eyes and smelt with my nose small-pox growing up in first specimens, either in close rooms or in overcrowded wards, where it could not by any possibility have been "caught," but must have begun. nay, more, i have seen diseases begin, grow up, and pass into one another. now, dogs do not pass into cats. i have seen, for instance, with a little overcrowding, continued fever grow up; and with a little more, typhoid fever; and with a little more, typhus, and all in the same ward or hut. would it not be far better, truer, and more practical, if we looked upon disease in this light? for diseases, as all experience shows, are adjectives, not noun substantives. [ ] [sidenote: lingering smell of paint a want of care.] that excellent paper, the _builder_, mentions the lingering of the smell of paint for a month about a house as a proof of want of ventilation. certainly--and, where there are ample windows to open, and these are never opened to get rid of the smell of paint, it is a proof of want of management in using the means of ventilation. of course the smell will then remain for months. why should it go? [ ] [sidenote: why let your patient ever be surprised?] why should you let your patient ever be surprised, except by thieves? i do not know. in england, people do not come down the chimney, or through the window, unless they are thieves. they come in by the door, and somebody must open the door to them. the "somebody" charged with opening the door is one of two, three, or at most four persons. why cannot these, at most, four persons be put in charge as to what is to be done when there is a ring at the door bell? the sentry at a post is changed much oftener than any servant at a private house or institution can possibly be. but what should we think of such an excuse as this: that the enemy had entered such a post because a and not b had been on guard? yet i have constantly heard such an excuse made in the private house or institution and accepted: viz., that such a person had been "let in" or _not_ "let in," and such a parcel had been wrongly delivered or lost because a and not b had opened the door! [ ] there are many physical operations where _coeteris paribus_ the danger is in a direct ratio to the time the operation lasts; and _coeteris paribus_ the operator's success will be in direct ratio to his quickness. now there are many mental operations where exactly the same rule holds good with the sick; _coeteris paribus_ their capability of bearing such operations depends directly on the quickness, _without hurry_, with which they can be got through. [ ] [sidenote: petty management better understood in institutions than in private houses.] so true is this that i could mention two cases of women of very high position, both of whom died in the same way of the consequences of a surgical operation. and in both cases, i was told by the highest authority that the fatal result would not have happened in a london hospital. [sidenote: what institutions are the exception?] but, as far as regards the art of petty management in hospitals, all the military hospitals i know must be excluded. upon my own experience i stand, and i solemnly declare that i have seen or know of fatal accidents, such as suicides in _delirium tremens_, bleedings to death, dying patients dragged out of bed by drunken medical staff corps men, and many other things less patent and striking, which would not have happened in london civil hospitals nursed by women. the medical officers should be absolved from all blame in these accidents. how can a medical officer mount guard all day and all night over a patient (say) in _delirium tremens_? the fault lies in there being no organized system of attendance. were a trustworthy _man_ in charge of each ward, or set of wards, not as office clerk, but as head nurse, (and head nurse the best hospital serjeant, or ward master, is not now and cannot be, from default of the proper regulations), the thing would not, in all probability, have happened. but were a trustworthy _woman_ in charge of the ward, or set of wards, the thing would not, in all certainty, have happened. in other words, it does not happen where a trustworthy woman is really in charge. and, in these remarks, i by no means refer only to exceptional times of great emergency in war hospitals, but also, and quite as much, to the ordinary run of military hospitals at home, in time of peace; or to a time in war when our army was actually more healthy than at home in peace, and the pressure on our hospitals consequently much less. [sidenote: nursing in regimental hospitals.] it is often said that, in regimental hospitals, patients ought to "nurse each other," because the number of sick altogether being, say, but thirty, and out of these one only perhaps being seriously ill, and the other twenty-nine having little the matter with them, and nothing to do, they should be set to nurse the one; also, that soldiers are so trained to obey, that they will be the most obedient, and therefore the best of nurses, add to which they are always kind to their comrades. now, have those who say this, considered that, in order to obey, you must know _how_ to obey, and that these soldiers certainly do not know how to obey in nursing. i have seen these "kind" fellows (and how kind they are no one knows so well as myself) move a comrade so that, in one case at least, the man died in the act. i have seen the comrades' "kindness" produce abundance of spirits, to be drunk in secret. let no one understand by this that female nurses ought to, or could be introduced in regimental hospitals. it would be most undesirable, even were it not impossible. but the head nurseship of a hospital serjeant is the more essential, the more important, the more inexperienced the nurses. undoubtedly, a london hospital "sister" does sometimes set relays of patients to watch a critical case; but, undoubtedly also, always under her own superintendence; and she is called to whenever there is something to be done, and she knows how to do it. the patients are not left to do it of their own unassisted genius, however "kind" and willing they may be. [ ] [sidenote: burning of the crinolines.] fortunate it is if her skirts do not catch fire--and if the nurse does not give herself up a sacrifice together with her patient, to be burnt in her own petticoats. i wish the registrar-general would tell us the exact number of deaths by burning occasioned by this absurd and hideous custom. but if people will be stupid, let them take measures to protect themselves from their own stupidity--measures which every chemist knows, such as putting alum into starch, which prevents starched articles of dress from blazing up. [sidenote: indecency of the crinolines.] i wish too that people who wear crinoline could see the indecency of their own dress as other people see it. a respectable elderly woman stooping forward, invested in crinoline, exposes quite as much of her own person to the patient lying in the room as any opera-dancer does on the stage. but no one will ever tell her this unpleasant truth. [ ] [sidenote: never speak to a patient in the act of moving.] it is absolutely essential that a nurse should lay this down as a positive rule to herself, never to speak to any patient who is standing or moving, as long as she exercises so little observation as not to know when a patient cannot bear it. i am satisfied that many of the accidents which happen from feeble patients tumbling down stairs, fainting after getting up, &c., happen solely from the nurse popping out of a door to speak to the patient just at that moment; or from his fearing that she will do so. and that if the patient were even left to himself, till he can sit down, such accidents would much seldomer occur. if the nurse accompanies the patient let her not call upon him to speak. it is incredible that nurses cannot picture to themselves the strain upon the heart, the lungs, and the brain, which the act of moving is to any feeble patient. [ ] [sidenote: careless observation of the results of careless visits.] as an old experienced nurse, i do most earnestly deprecate all such careless words. i have known patients delirious all night, after seeing a visitor who called them "better," thought they "only wanted a little amusement," and who came again, saying, "i hope you were not the worse for my visit," neither waiting for an answer, nor even looking at the case. no real patient will ever say, "yes, but i was a great deal the worse." it is not, however, either death or delirium of which, in these cases, there is most danger to the patient. unperceived consequences are far more likely to ensue. _you_ will have impunity--the poor patient will _not_. that is, the patient will suffer, although neither he nor the inflictor of the injury will attribute it to its real cause. it will not be directly traceable, except by a very careful observant nurse. the patient will often not even mention what has done him most harm. [ ] [sidenote: the sick would rather be told a thing than have it read to them.] sick children, if not too shy to speak, will always express this wish. they invariably prefer a story to be _told_ to them, rather than read to them. [ ] [sidenote: sick suffer to excess from mental as well as bodily pain.] it is a matter of painful wonder to the sick themselves how much painful ideas predominate over pleasurable ones in their impressions; they reason with themselves; they think themselves ungrateful; it is all of no use. the fact is, that these painful impressions are far better dismissed by a real laugh, if you can excite one by books or conversation, than by any direct reasoning; or if the patient is too weak to laugh, some impression from nature is what he wants. i have mentioned the cruelty of letting him stare at a dead wall. in many diseases, especially in convalescence from fever, that wall will appear to make all sorts of faces at him; now flowers never do this. form, colour, will free your patient from his painful ideas better than any argument. [ ] [sidenote: desperate desire in the sick to "see out of window."] i remember a case in point. a man received an injury to the spine, from an accident, which after a long confinement ended in death. he was a workman--had not in his composition a single grain of what is called "enthusiasm for nature,"--but he was desperate to "see once more out of window." his nurse actually got him on her back, and managed to perch him up at the window for an instant, "to see out." the consequence to the poor nurse was a serious illness, which nearly proved fatal. the man never knew it; but a great many other people did. yet the consequence in none of their minds, so far as i know, was the conviction that the craving for variety in the starving eye, is just as desperate as that for food in the starving stomach, and tempts the famishing creature in either case to steal for its satisfaction. no other word will express it but "desperation." and it sets the seal of ignorance and stupidity just as much on the governors and attendants of the sick if they do not provide the sick-bed with a "view" of some kind, as if they did not provide the hospital with a kitchen. [ ] [sidenote: physical effect of colour.] no one who has watched the sick can doubt the fact, that some feel stimulus from looking at scarlet flowers, exhaustion from looking at deep blue, &c. [ ] [sidenote: nurse must have some rule of time about the patient's diet.] why, because the nurse has not got some food to-day which the patient takes, can the patient wait four hours for food to-day, who could not wait two hours yesterday? yet this is the only logic one generally hears. on the other hand, the other logic, viz., of the nurse giving a patient a thing because she _has_ got it, is equally fatal. if she happens to have fresh jelly, or fresh fruit, she will frequently give it to the patient half-an-hour after his dinner, or at his dinner, when he cannot possibly eat that and the broth too--or worse still leave it by his bed-side till he is so sickened with the sight of it, that he cannot eat it at all. [ ] [sidenote: intelligent cravings of particular sick for particular articles of diet.] in the diseases produced by bad food, such as scorbutic dysentery and diarrhoea, the patient's stomach often craves for and digests things, some of which certainly would be laid down in no dietary that ever was invented for sick, and especially not for such sick. these are fruit, pickles, jams, gingerbread, fat of ham or of bacon, suet, cheese, butter, milk. these cases i have seen not by ones, nor by tens, but by hundreds. and the patient's stomach was right and the book was wrong. the articles craved for, in these cases, might have been principally arranged under the two heads of fat and vegetable acids. there is often a marked difference between men and women in this matter of sick feeding. women's digestion is generally slower. [ ] it is made a frequent recommendation to persons about to incur great exhaustion, either from the nature of the service or from their being not in a state fit for it, to eat a piece of bread before they go. i wish the recommenders would themselves try the experiment of substituting a piece of bread for a cup of tea or coffee or beef tea as a refresher. they would find it a very poor comfort. when soldiers have to set out fasting on fatiguing duty, when nurses have to go fasting in to their patients, it is a hot restorative they want, and ought to have, before they go, not a cold bit of bread. and dreadful have been the consequences of neglecting this. if they can take a bit of bread _with_ the hot cup of tea, so much the better, but not _instead_ of it. the fact that there is more nourishment in bread than in almost anything else has probably induced the mistake. that it is a fatal mistake there is no doubt. it seems, though very little is known on the subject, that what "assimilates" itself directly and with the least trouble of digestion with the human body is the best for the above circumstances. bread requires two or three processes of assimilation, before it becomes like the human body. the almost universal testimony of english men and women who have undergone great fatigue, such as riding long journeys without stopping, or sitting up for several nights in succession, is that they could do it best upon an occasional cup of tea--and nothing else. let experience, not theory, decide upon this as upon all other things. [ ] in making coffee, it is absolutely necessary to buy it in the berry and grind it at home. otherwise you may reckon upon its containing a certain amount of chicory, _at least_. this is not a question of the taste or of the wholesomeness of chicory. it is that chicory has nothing at all of the properties for which you give coffee. and therefore you may as well not give it. again, all laundresses, mistresses of dairy-farms, head nurses (i speak of the good old sort only--women who unite a good deal of hard manual labour with the head-work necessary for arranging the day's business, so that none of it shall tread upon the heels of something else) set great value, i have observed, upon having a high-priced tea. this is called extravagant. but these women are "extravagant" in nothing else. and they are right in this. real tea-leaf tea alone contains the restorative they want; which is not to be found in sloe-leaf tea. the mistresses of houses, who cannot even go over their own house once a day, are incapable of judging for these women. for they are incapable themselves, to all appearance, of the spirit of arrangement (no small task) necessary for managing a large ward or dairy. [ ] [sidenote: nurses often do not think the sick room any business of theirs, but only the sick.] i once told a "very good nurse" that the way in which her patient's room was kept was quite enough to account for his sleeplessness; and she answered quite good-humouredly she was not at all surprised at it--as if the state of the room were, like the state of the weather, entirely out of her power. now in what sense was this woman to be called a "nurse?" [ ] for the same reason if, after washing a patient, you must put the same night-dress on him again, always give it a preliminary warm at the fire. the night-gown he has worn must be, to a certain extent, damp. it has now got cold from having been off him for a few minutes. the fire will dry and at the same time air it. this is much more important than with clean things. [ ] [sidenote: how a room is _dusted_.] if you like to clean your furniture by laying out your clean clothes upon your dirty chairs or sofa, this is one way certainly of doing it. having witnessed the morning process called "tidying the room," for many years, and with ever-increasing astonishment, i can describe what it is. from the chairs, tables, or sofa, upon which the "things" have lain during the night, and which are therefore comparatively clean from dust or blacks, the poor "_things_" having "caught" it, they are removed to other chairs, tables, sofas, upon which you could write your name with your finger in the dust or blacks. the _other_ side of the "things" is therefore now evenly dirtied or dusted. the housemaid then flaps every thing, or some things, not out of her reach, with a thing called a duster--the dust flies up, then re-settles more equally than it lay before the operation. the room has now been "put to rights." [ ] [sidenote: atmosphere in painted and papered rooms quite distinguishable.] i am sure that a person who has accustomed her senses to compare atmospheres proper and improper, for the sick and for children, could tell, blindfold, the difference of the air in old painted and in old papered rooms, _coeteris paribus_. the latter will always be musty, even with all the windows open. [ ] [sidenote: how to keep your wall clean at the expense of your clothes.] if you like to wipe your dirty door, or some portion of your dirty wall, by hanging up your clean gown or shawl against it on a peg, this is one way certainly, and the most usual way, and generally the only way of cleaning either door or wall in a bed-room! [ ] [sidenote: absurd statistical comparisons made in common conversation by the most sensible people for the benefit of the sick.] there are, of course cases, as in first confinements, when an assurance from the doctor or experienced nurse to the frightened suffering woman that there is nothing unusual in her case, that she has nothing to fear but a few hours' pain, may cheer her most effectually. this is advice of quite another order. it is the advice of experience to utter inexperience. but the advice we have been referring to is the advice of inexperience to bitter experience; and, in general, amounts to nothing more than this, that _you_ think _i_ shall recover from consumption, because somebody knows somebody somewhere who has recovered from fever. i have heard a doctor condemned whose patient did not, alas! recover, because another doctor's patient of a _different_ sex, of a _different_ age, recovered from a _different_ disease, in a _different_ place. yes, this is really true. if people who make these comparisons did but know (only they do not care to know), the care and preciseness with which such comparisons require to be made, (and are made), in order to be of any value whatever, they would spare their tongues. in comparing the deaths of one hospital with those of another, any statistics are justly considered absolutely valueless which do not give the ages, the sexes, and the diseases of all the cases. it does not seem necessary to mention this. it does not seem necessary to say that there can be no comparison between old men with dropsies and young women with consumptions. yet the cleverest men and the cleverest women are often heard making such comparisons, ignoring entirely sex, age, disease, place--in fact, _all_ the conditions essential to the question. it is the merest _gossip_. [ ] a small pet animal is often an excellent companion for the sick, for long chronic cases especially. a pet bird in a cage is sometimes the only pleasure of an invalid confined for years to the same room. if he can feed and clean the animal himself, he ought always to be encouraged to do so. [ ] it is a much more difficult thing to speak the truth than people commonly imagine. there is the want of observation _simple_, and the want of observation _compound_, compounded, that is, with the imaginative faculty. both may equally intend to speak the truth. the information of the first is simply defective. that of the second is much more dangerous. the first gives, in answer to a question asked about a thing that has been before his eyes perhaps for years, information exceedingly imperfect, or says, he does not know. he has never observed. and people simply think him stupid. the second has observed just as little, but imagination immediately steps in, and he describes the whole thing from imagination merely, being perfectly convinced all the while that he has seen or heard it; or he will repeat a whole conversation, as if it were information which had been addressed to him; whereas it is merely what he has himself said to somebody else. this is the commonest of all. these people do not even observe that they have _not_ observed nor remember that they have forgotten. courts of justice seem to think that any body can speak "the whole truth and nothing but the truth," if he does but intend it. it requires many faculties combined of observation and memory to speak "the whole truth" and to say "nothing but the truth." "i knows i fibs dreadful: but believe me, miss, i never finds out i have fibbed until they tells me so," was a remark actually made. it is also one of much more extended application than most people have the least idea of. concurrence of testimony, which is so often adduced as final proof, may prove nothing more, as is well known to those accustomed to deal with the unobservant imaginative, than that one person has told his story a great many times. i have heard thirteen persons "concur" in declaring that a fourteenth, who had never left his bed, went to a distant chapel every morning at seven o'clock. i have heard persons in perfect good faith declare, that a man came to dine every day at the house where they lived, who had never dined there once; that a person had never taken the sacrament, by whose side they had twice at least knelt at communion; that but one meal a day came out of a hospital kitchen, which for six weeks they had seen provide from three to five and six meals a day. such instances might be multiplied _ad infinitum_ if necessary. [ ] this is important, because on this depends what the remedy will be. if a patient sleeps two or three hours early in the night, and then does not sleep again at all, ten to one it is not a narcotic he wants, but food or stimulus, or perhaps only warmth. if on the other hand, he is restless and awake all night, and is drowsy in the morning, he probably wants sedatives, either quiet, coolness, or medicine, a lighter diet, or all four. now the doctor should be told this, or how can he judge what to give? [ ] [sidenote: more important to spare the patient thought than physical exertion.] it is commonly supposed that the nurse is there to spare the patient from making physical exertion for himself--i would rather say that she ought to be there to spare him from taking thought for himself. and i am quite sure, that if the patient were spared all thought for himself, and _not_ spared all physical exertion, he would be infinitely the gainer. the reverse is generally the case in the private house. in the hospital it is the relief from all anxiety, afforded by the rules of a well-regulated institution, which has often such a beneficial effect upon the patient. [ ] [sidenote: english women have great capacity of but little practice in close observation.] it may be too broad an assertion, and it certainly sounds like a paradox. but i think that in no country are women to be found so deficient in ready and sound observation as in england, while peculiarly capable of being trained to it. the french or irish woman is too quick of perception to be so sound an observer--the teuton is too slow to be so ready an observer as the english woman might be. yet english women lay themselves open to the charge so often made against them by men, viz., that they are not to be trusted in handicrafts to which their strength is quite equal, for want of a practised and steady observation. in countries where women (with average intelligence certainly not superior to that of englishwomen) are employed, e.g., in dispensing, men responsible for what these women do (not theorizing about man's and woman's "missions"), have stated that they preferred the service of women to that of men, as being more exact, more careful, and incurring fewer mistakes of inadvertence. now certainly englishwomen are peculiarly capable of attaining to this. i remember when a child, hearing the story of an accident, related by some one who sent two girls to fetch a "bottle of salvolatile from her room;" "mary could not stir," she said, "fanny ran and fetched a bottle that was not salvolatile, and that was not in my room." now this sort of thing pursues every one through life. a woman is asked to fetch a large new bound red book, lying on the table by the window, and she fetches five small old boarded brown books lying on the shelf by the fire. and this, though she has "put that room to rights" every day for a month perhaps, and must have observed the books every day, lying in the same places, for a month, if she had any observation. habitual observation is the more necessary, when any sudden call arises. if "fanny" had observed "the bottle of salvolatile" in "the aunt's room," every day she was there, she would more probably have found it when it was suddenly wanted. there are two causes for these mistakes of inadvertence. . a want of ready attention; only part of the request is heard at all. . a want of the habit of observation. to a nurse i would add, take care that you always put the same things in the same places; you don't know how suddenly you may be called on some day to find something, and may not be able to remember in your haste where you yourself had put it, if your memory is not in the habit of seeing the thing there always. [ ] [sidenote: approach of death, paleness by no means an invariable effect, as we find in novels.] it falls to few ever to have had the opportunity of observing the different aspects which the human face puts on at the sudden approach of certain forms of death by violence; and as it is a knowledge of little use i only mention it here as being the most startling example of what i mean. in the nervous temperament the face becomes pale (this is the only _recognized_ effect); in the sanguine temperament purple; in the bilious yellow, or every manner of colour in patches. now, it is generally supposed that paleness is the one indication of almost any violent change in the human being, whether from terror, disease, or anything else. there can be no more false observation. granted, it is the one recognized livery, as i have said--_de rigueur_ in novels, but nowhere else. [ ] i have known two cases, the one of a man who intentionally and repeatedly displaced a dislocation, and was kept and petted by all the surgeons, the other of one who was pronounced to have nothing the matter with him, there being no organic change perceptible, but who died within the week. in both these cases, it was the nurse who, by accurately pointing out what she had accurately observed, to the doctors, saved the one case from persevering in a fraud, the other from being discharged when actually in a dying state. i will even go further and say, that in diseases which have their origin in the feeble or irregular action of some function, and not in organic change, it is quite an accident if the doctor who sees the case only once a day, and generally at the same time, can form any but a negative idea of its real condition. in the middle of the day, when such a patient has been refreshed by light and air, by his tea, his beef tea, and his brandy, by hot bottles to his feet, by being washed and by clean linen, you can scarcely believe that he is the same person as lay with a rapid fluttering pulse, with puffed eye-lids, with short breath, cold limbs, and unsteady hands, this morning. now what is a nurse to do in such a case? not cry, "lord bless you, sir, why you'd have thought he were a dying all night." this may be true, but it is not the way to impress with the truth a doctor, more capable of forming a judgment from the facts, if he did but know them, than you are. what he wants is not your opinion, however respectfully given, but your facts. in all diseases it is important, but in diseases which do not run a distinct and fixed course, it is not only important, it is essential that the facts the nurse alone can observe, should be accurately observed, and accurately reported to the doctor. i must direct the nurse's attention to the extreme variation there is not unfrequently in the pulse of such patients during the day. a very common case is this: between and a.m. the pulse becomes quick, perhaps , and so thready it is not like a pulse at all, but like a string vibrating just underneath the skin. after this the patient gets no more sleep. about mid-day the pulse has come down to ; and though feeble and compressible is a very respectable pulse. at night, if the patient has had a day of excitement, it is almost imperceptible. but, if the patient has had a good day, it is stronger and steadier and not quicker than at mid-day. this is a common history of a common pulse; and others, equally varying during the day, might be given. now, in inflammation, which may almost always be detected by the pulse, in typhoid fever, which is accompanied by the low pulse that nothing will raise, there is no such great variation. and doctors and nurses become accustomed not to look for it. the doctor indeed cannot. but the variation is in itself an important feature. cases like the above often "go off rather suddenly," as it is called, from some trifling ailment of a few days, which just makes up the sum of exhaustion necessary to produce death. and everybody cries, who would have thought it? except the observing nurse, if there is one, who had always expected the exhaustion to come, from which there would be no rally, because she knew the patient had no capital in strength on which to draw, if he failed for a few days to make his barely daily income in sleep and nutrition. i have often seen really good nurses distressed, because they could not impress the doctor with the real danger of their patient; and quite provoked because the patient "would look," either "so much better" or "so much worse" than he really is "when the doctor was there." the distress is very legitimate, but it generally arises from the nurse not having the power of laying clearly and shortly before the doctor the facts from which she derives her opinion, or from the doctor being hasty and inexperienced, and not capable of eliciting them. a man who really cares for his patients, will soon learn to ask for and appreciate the information of a nurse, who is at once a careful observer and a clear reporter. [ ] [sidenote: danger of physicking by amateur females.] i have known many ladies who, having once obtained a "blue pill" prescription from a physician, gave and took it as a common aperient two or three times a week--with what effect may be supposed. in one case i happened to be the person to inform the physician of it, who substituted for the prescription a comparatively harmless aperient pill. the lady came to me and complained that it "did not suit her half so well." if women will take or give physic, by far the safest plan is to send for "the doctor" every time--for i have known ladies who both gave and took physic, who would not take the pains to learn the names of the commonest medicines, and confounded, e.g., colocynth with colchicum. this _is_ playing with sharp edged tools "with a vengeance." there are excellent women who will write to london to their physician that there is much sickness in their neighbourhood in the country, and ask for some prescription from him, which they used to like themselves, and then give it to all their friends and to all their poorer neighbours who will take it. now, instead of giving medicine, of which you cannot possibly know the exact and proper application, nor all its consequences, would it not be better if you were to persuade and help your poorer neighbours to remove the dung-hill from before the door, to put in a window which opens, or an arnott's ventilator, or to cleanse and lime-wash the cottages? of these things the benefits are sure. the benefits of the inexperienced administration of medicines are by no means so sure. homoeopathy has introduced one essential amelioration in the practice of physic by amateur females; for its rules are excellent, its physicking comparatively harmless--the "globule" is the one grain of folly which appears to be necessary to make any good thing acceptable. let then women, if they will give medicine, give homoeopathic medicine. it won't do any harm. an almost universal error among women is the supposition that everybody _must_ have the bowels opened once in every twenty-four hours or must fly immediately to aperients. the reverse is the conclusion of experience. this is a doctor's subject, and i will not enter more into it; but will simply repeat, do not go on taking or giving to your children your abominable "courses of aperients," without calling in the doctor. it is very seldom indeed, that by choosing your diet, you cannot regulate your own bowels; and every woman may watch herself to know what kind of diet will do this; i have known deficiency of meat produce constipation, quite as often as deficiency of vegetables; baker's bread much oftener than either. home made brown bread will oftener cure it than anything else. [ ] a curious fact will be shown by table a, viz., that , out of , , or nearly one-half of all the nurses, in domestic service, are between and years of age. printed by harrison and sons, st. martin's lane, w.c. * * * * * a summer search for sir john franklin, with a peep into the polar basin, by commander e.a. inglefield, r.n. demy vo., s. french naval tactics; translated from the french by augustus phillimore, captain, r.n. demy vo., s. despatches and papers relative to campaign in turkey, asia minor, and the crimea in - , by captain sayer. despatches of viscount hardinge, lord gough, and sir harry smith. demy vo., s. present state of the turkish empire, by marshal marmont, translated by general sir f. smith, k.h., f.r.s. second edition, post vo., s. d. pastoral and other poems, by mrs. george halse, fcap. vo., s. d. cloth. the laurel and the palm, by mrs. challice, cloth, s. eda morton and her cousins. fcap. vo., s. cavendish, or the patrician at sea, by w. johnson neale. fcap. vo., cloth. s. d. chollerton, a tale of our own times, fcap. vo, s. d. evelina, by miss burney. fcap. vo., s. * * * * * harrison, , pall mall, london, s.w., bookseller to the queen. the parish choir, or church music book, in vols., s. cloth. a plain tract on singing in public worship. d., or s. per . conversations on the choral service, being an examination of popular prejudices against church music. fcap, vo., s. bishop blomfield and his times, by the rev. g.e. biber, ll.d. vol., post vo., s. d. a plain tract on church ornaments, d., or s. per . how to stop and when to stop; punctuation reduced to a system. fcap. vo., cloth, s. anthems for parish choirs, collected and edited by the rev. sir w.h. cope, bart. vol., to., s. german, in fifty lessons, by herr c.a.a. bran, fcap. vo., s. d. the turkish campaigner's vade-mecum of the ottoman colloquial language, by j.w. redhouse, f.r.a.s. pocket edition, s. cloth. comparative grammar of the dravidian or south-indian family of languages, by the rev. r. caldwell, b.a. demy vo., cloth. s. * * * * * [transcriber's note: the following advertisements were at the beginning of the original text but have been moved here for ease of reading.] london: harrison, bookseller to the queen, , pall mall. * * * * * [illustration] sir bernard burke's (ulster king of arms) peerage and baronetage for . in vol., royal vo., price s., nd edition. contents introduction--(short history of the peerage and baronetage--rights and privileges--and origin; engravings and heraldic descriptions of the royal crown and the coronets of the nobility) royal family. kings of scotland. house of guelph. peers entitled to quarter the plantagenet arms dictionary--including the peerage and baronetage of england, ireland, and scotland, and the united kingdom. scale of precedence. spiritual lords. foreign titles of nobility borne by british subjects. peerages recently extinct. peerages claimed. surnames of peers and peeresses, with heirs apparent and presumptive. courtesy titles of eldest sons. peerage of the three kingdoms, collectively, in order of precedence. baronets in order of precedence. privy councils of england and ireland. orders of knighthood: garter, thistle, st. patrick, bath, st. michael and st. george, and guelphic. knights bachelors. mottoes translated, with illustrations. seats and mansions of peers and baronets, alphabetically arranged. daughters of peers married to commoners. * * * * * "the best genealogical and heraldic dictionary of the peerage and baronetage."--_globe._ "for the amazing quantity of personal and family history, admirable arrangements of details, and accuracy of information, this genealogical and heraldic dictionary is without a rival. it is now the standard and acknowledged book of reference upon all questions touching pedigree."--_morning post._ "nowhere else is there to be found so full an account of the families of men newly admitted in the peerage or the baronetage. * * * * the minutest change to the date of publication will be found recorded in this volume, which is in fact a peerage and baronetage, not only beyond comparison with any other book of the same class extent, but while it remains as it now is, perfect of its kind above all risk from any future competition."--_examiner._ "the book combines, in one volume, and at one view, what no other work of the kind has ever done, the complete past genealogy, and now living condition, of the family of each peer and baronet of great britain and ireland. * * * burke's peerage and baronetage may be fairly looked on us the golden book of the hereditary rank and aristocracy of the british empire."--_morning post._ "burke's peerage and baronetage is now quite a national annual."--_illus. london news._ complete in volume, price [transcriber's note: price unclear in original]s. d. sir bernard burke's (ulster king of arms) landed gentry of great britain and ireland. "a work of this kind is of a national value."--_morning post._ "a work in which every gentleman will find a domestic interest, as it contains the fullest account of every known family in the united kingdom."--_bell's messenger._ "a [transcriber's note: word unclear in original] work, now for the first time complete in one very handsome and portly volume, has just been published."--_illustrated london news._ now ready, price s. d. the foreign office list for , exhibiting the rank, standing, and various services of every person employed in the foreign office, the diplomatic corps, and the consular body. and also regulations respecting examinations, passports, foreign orders, &c. compiled by francis w.h. cavendish and edward hertslet. easy anthems. for four voices, with organ or piano forte accompaniments. o love the lord goldwin d. praise the lord okeland d. for unto us a child is born haselton d. o praise god in his holiness weldon d. behold, now praise the lord rogers d. deliver us, o lord our god batten } d teach me, o lord rogers } o praise the lord weldon d. veni, creator spiritus tallis d. out of the deep aldrich d. the above anthems, forming part i, may also be had in wrapper, s. o praise the lord batten d. plead thou my cause glareanus d. praise the lord, o jerusalem scott d. my soul truly waiteth batten d. if ye love me tallis d. thou visitest the earth greene d. o how amiable richardson } offertory anthem whitbroke } d. not unto us, o lord aldrich d. hear my prayer batten d. lord, who shall dwell rogers d. the above anthems, forming part ii, may also be had in wrapper, s. have mercy upon me gibbs d. wherewithal shall a young man alcock d. i give you a new commandment shephard d. holy, holy, holy bishop d. call to remembrance farrant d. teach me thy way, o lord fox } blessed art thou, o lord weldon } d. o israel, trust in the lord croft d. blessing and glory boyce d. lilt up your heads turner d. thou knowest, lord purcell } set up thyself, o god wise } d. behold now, praise the lord creyghton d. gloria in excelsis s. mark's use d. the above anthems, forming part iii, may also be had in wrapper, s. _the three parts, forming vol. i of easy anthems, may be had, neatly bound together in cloth, price s._ o praise the lord goldwin d. o give thanks rogers } lord, we beseech thee batten } d. offertory anthems monk d. glory be to god on high loosemore d. lord, for thy tender mercies farrant d. o lord, grant the king child behold how good and joyful rogers d. the lord is king king d. sing we merrily batten d. o pray for the peace rogers d. the above anthems, forming part iv, may also be had in wrapper, s. * * * * * anthems for parish choirs, _by eminent composers of the english church._ collected and edited by the rev. sir william h. cope, bart., minor canon of st. peter's, westminster. no. i. (price d.) contains: sing we merrily adrian batten let my complaint ditto i will not leave you comfortless dr. william byrde no. ii. (price d.) contains: o clap your hands dr. william child when the lord turned again adrian batten o pray for the peace of jerusalem dr. benj. rogers how long wilt thou forget me ditto no. iii. (price s.) contains: oh! that the salvation dr. benj. rogers praise the lord, o my soul ditto o give thanks unto the lord ditto save me, o god ditto behold how good and joyful ditto no. iv. (price d.) contains: by the waters of babylon rev. dr. h. aldrich not unto us, o lord thomas kelway o praise the lord all ye heathen john goldwin no. v. (price d.) contains: haste thee, o god, to deliver me adrian batten why art thou so heavy dr. orlando gibbons behold now praise the lord rev. dr. h. aldrich no. vi. (price d.) contains: praise the lord, o my soul dr. john blow in thee, o lord, have i put my trust william evans no. vii. (price d.) contains: unto thee o lord, will i lift up thomas kelway the lord is king william king in the beginning, o lord matthew lock no. viii (price s.) contains: let god arise matthew lock sing unto the lord a new song ditto when the son of man shall come ditto lord, we beseech thee adrian batten no. ix. (price d.) contains: o lord, i have loved the habitation thomas tomkins great and marvellous ditto he that hath pity upon the poor ditto no. x. (price d.) contains: o lord god of our salvation rev. dr. h. aldrich lord, who shall dwell adrian batten o praise the lord: laud ye dr. william child the red cross girls with the russian army [illustration: barbara presented him with the electric lamp. (_see page ._)] the red cross girls with the russian army by margaret vandercook author of "the ranch girls series," "stories about camp fire girls series," etc. illustrated the john c. winston company philadelphia copyright, , by the john c. winston co. contents chapter page i. a peasant's hut in russia ii. a former acquaintance iii. general alexis iv. an encounter v. out of the past vi. the arrest vii. a russian church viii. another warning ix. the attack x. mildred's opportunity xi. a russian retreat xii. petrograd xiii. the next step xiv. mildred's return xv. the winter palace xvi. the unexpected happens xvii. the departure xviii. a poem and a conversation xix. the reunion chapter i _a peasant's hut in russia_ in the last volume of the red cross series the four american girls spent six months in tragic little belgium. there, in an american hospital in brussels, devoted to the care, not of wounded soldiers, but of ill belgians, three of the girls lived and worked. but eugenia went alone to dwell in a house in the woods because the cry of the children in belgium made the strongest appeal to her. the house was a lonely one, supposed to be haunted, yet in spite of this eugenia moved in. there the money of the girl whom her friend had once believed "poor as a church mouse" fed and cared for her quickly acquired family. in eugenia's haunted house were other sojourners furnishing the mystery of this story and endangering her liberty, almost her life. they were a belgian officer and his family whom the red cross girl kept in hiding. somehow the officer had managed to return to his own country from the fighting line in belgium. after securing the papers he desired from the enemy, by eugenia's aid, he was enabled to return once more to king albert and the allied armies. thus eugenia was left alone to bear the brunt of the german displeasure after the discovery of her misdeeds. she was imprisoned in brussels, and became dangerously ill. finally, because she was an american, eugenia was made to leave the country, rather than to suffer the punishment which would have been hers had she belonged to another nationality. but the four american red cross girls also had the companionship of dick thornton during their stay in the once lovely capital of belgium. dick had not recovered the use of his arm, but in spite of this had come to brussels to help with the work of the american relief society. here his once friendly relation with barbara meade no longer existed. because of her change of attitude he apparently grew more attached to nona davis. however, at the close of the story, when barbara is taking eugenia back to southern france, she and dick unexpectedly meet aboard a fog-bound ship. and in the darkness the light finally shines when dick and barbara discover at last that their feeling for each other is stronger than friendship. later, near "the pool of truth" not far from the "farmhouse with the blue front door," eugenia peabody again meets captain henri castaigne, the young french officer whom she had once nursed back to health. a short time afterwards he and eugenia are married. later the three other american red cross girls decide to continue their nursing of the wounded soldiers of the allied armies in far-off russia. one cold october afternoon three american girls were standing in the stone courtyard of a great russian fortress near the border line of poland. situated upon a cone-shaped hill, the fort itself had been built like the three sides of a square, with the yard as the center. along the fourth side ran a cement wall with a single iron gate. evidently the three girls were engaged in red cross work, for they wore the familiar service uniforms. one of them had on a heavy coat and cap, but the other two must have just come out of doors for a few moments. indeed, their first words revealed this fact. "i really don't feel that you should be starting upon this expedition alone, nona," mildred thornton argued. she was a tall girl, with heavy, flaxen hair and quiet, steel-gray eyes. she was gazing anxiously about her, for russia was a new and strange world to the three american red cross nurses, who had arrived at their present headquarters only a few weeks before. nearly a year had passed since the four friends separated in belgium. then mildred and nona davis had remained at their posts to care for the homeless belgian children, while barbara meade and eugenia peabody returned to southern france. now at the close of mildred thornton's speech to nona, barbara meade frowned. she was poised on one foot as if expecting to flee at any moment. "i quite agree with you, mildred," she protested. "nona's message was far too mysterious and vague to consider answering. we must not forget that we are now in a country and among a people whom we don't understand in the least. besides, i promised both dick and eugenia that we would be more careful. how i wish one or the other of them were here to advise us!" shivering, barbara, who was the youngest and smallest of the girls, slipped her arm through mildred's. a few yards before them sentries were marching slowly up and down, with their rifles resting on their shoulders, while a double row guarded a single wide gate. every now and then a common soldier passed on his way to the performance of some special duty. gray and colorless, the afternoon had a peculiar dampness as if the wind had blown across acres of melting snow. nevertheless in reply to her friends' objections nona davis shook her head. "yes, i realize you may both be right, and yet so urgent was my message that i feel compelled to do what was asked of me. but don't worry about me, i have the letter with the directions safe in my pocket. good-by." then before either of the other girls could find time to argue the point a second time, the young southern girl had kissed each of them and turned away. later they saw her give the password at the gate and the sentry allow her to pass out. before her lay a stretch of sparsely settled country divided by a wide and much traveled road. several miles further along a wide river crossed the land, but near at hand there were only small farms and meagre clumps of pine woods. after a few more words of disapproval, barbara meade shrugged her shoulders, and then she and mildred re-entered the small curved doorway of the russian fort. the left wing was being used as a hospital for the wounded, while the rest of the great fortification was crowded with officers and soldiers. these men were being held in reserve to await the threatened invasion of the oncoming german hosts. warsaw had fallen and one by one the ancient russian fortifications once deemed invincible had given way before the german guns. but here at grovno, under the command of the great general alexis, the russians were to make a final stand. however, without thinking of anything save personal matters, nona davis first set out along the main traveled road. now and then she was compelled to step aside to let a great ox cart go past; these carts were filled with provisions being brought into the fort. occasionally a covered car rattled past loaded with munitions of war, or a heavy piece of artillery drawn on low trucks. but one would like to have seen a far greater quantity of supplies of all kinds being brought to the old fortress. it was an open secret that the supply of munitions was not what it should be, and yet grovno was expected to withstand all attacks. but the young american girl was not reflecting upon the uncertainties of war during her walk. neither did she feel any nervousness because of the newness of her surroundings, for the country in the rear of the fortifications was chiefly inhabited by russian women and children and a few old men. nona walked on quickly and with a speed and careless grace that covered the ground without apparent effort. she was looking extremely well, but above all other things nona davis appeared supremely interested. for some reason, still unknown to her, she had been more stirred and excited by the coming into russia than any country she had yet seen. she both admired and feared the russian people, with their curious combination of poetry and stupidity, of dullness and passion. before returning to her own land she meant to try and understand them better. for somewhere she had read that the future art of the world was to come forth from russia. it is the slavic temperament and not the anglo-saxon that best expresses itself in music and literature. nona's errand this afternoon was a curious and puzzling one, fraught with unnecessary mystery. four days before, a russian boy about twelve years old had appeared at the gate of the fortress at grovno, bearing a note addressed to miss nona davis. oddly enough, although the note was written in perfect english, it was not signed. in spite of this it requested that the american girl come to a small house about a mile and a half away to see a former friend. but who the friend could be, not one of the three girls could imagine. yet they scarcely talked of anything else. nona had no acquaintances in russia save the people she had met in connection with her work, and there was no one in her past whom she could possibly conceive of having come into russia as a tourist at such a time. therefore it was mildred thornton's and barbara meade's opinion that nona should pay not the slightest heed to such a communication. anonymous letters lead to nothing but evil. but in spite of their objections, here at the first possible opportunity nona was obeying the behest. probably she could not have explained why, for she was too sensible not to appreciate that possible discomfort and even danger might lie ahead of her. perhaps as much as anything she was actuated by a spirit of sheer adventure. so it is little wonder that during her walk nona's thoughts were now and then engaged with her own affairs. yet after a little her attention wandered from the immediate future and she fell to recalling the history of the past years' experiences, her own and her three friends. no wonder barbara was often lonely and homesick for dick thornton. she had become engaged to him on the fog-bound trip she had made with him in getting eugenia safely out of belgium. remembering eugenia's escape, nona said a short prayer of thankfulness. after her hiding of the belgian officer and his family from the german authorities, she would never have been allowed to leave belgium unpunished had she not been an american woman. remembering the fate of the english girl who had committed the same crime, nona appreciated how much they had to be thankful for. and now eugenia was married to captain castaigne, the young french officer. curious that among the four of them who had come from the united states to do red cross work among the allies, eugenia should be the first to marry! she, a new england old maid, disapproving of matrimony and, above all, of international marriages! yet the wedding had taken place in the previous spring at the little french "farmhouse with the blue front door," where the four girls had spent the most cheerful months since their arrival in europe for the war nursing. only once had nona and mildred deserted their posts in belgium, where they had continued eugenia's work of caring for the homeless belgian children. then they had gone to attend her wedding, but had returned to belgium as soon as possible. but eugenia and captain castaigne had taken scarcely more time for their own honeymoon. soon after the ceremony captain castaigne had gone to rejoin his regiment and three days after eugenia had become a member of the staff of a french hospital near her husband's line of trenches. so it turned out that barbara meade was left at the chateau d'amélie, as madame castaigne's friend and companion. dick thornton boarded in the village near by, so that he and barbara had a number of happy months together. but dick had finally decided that he must return to america and had urged barbara and his sister mildred to return with him. of course, nona had been invited to accompany them, but no special pressure had been brought upon her. however, mildred did not feel that her red cross work in europe was finished, while barbara refused to desert her friends. but barbara had another reason for her decision: she desired dick to be alone when he confessed their engagement to his mother and father. barbara had little fear of judge thornton's disapproval, but felt reasonably convinced that mrs. thornton would be both disappointed and aggrieved. certainly she had never hesitated to announce that she expected her son dick to make a brilliant match. how could she then be satisfied with a western girl of no wealth or distinction? it happened that dick thornton also had a private reason for finally agreeing to barbara's wish. his experiences in the past two years had given him a new point of view toward life. no longer was he willing to be known only as his father's son and to continue being supported by him. before dick married he intended making a position for himself, so as to be able to take care of his own wife. nona also recalled that she was really responsible for their coming into russia. it had seemed to her that they must make their red cross work complete by nursing in the largest of the allied countries. however, nona had now to cease her reflections, for she had come to a place in the road where she had been told to turn aside. to make sure the girl opened her note and re-read it for probably the tenth time. yes, here were the three pine trees, green shadows against the autumn sky, and here also was the narrow path that began alongside of them. after another fifteen minutes' walk nona discovered that she was approaching a hut of the poorest character. it was built of logs, with mud roughly filling up a number of cracks. already nona was learning to understand that the russian poor are perhaps the poorest people in the world. this hut was not so poverty-stricken as many others she had seen; at least, there were two windows and a front door. outside a hungry dog prowled about, showing not the slightest interest in the newcomer. yet nona was vaguely frightened. she stopped for a moment to reflect. should she go in or not? the place looked ugly and depressing and she could see no signs of human beings. yet perhaps there was illness inside the house and she had been sent for to give aid. if that were true she must not hesitate. as nona lifted her hand to knock at the door, suddenly it occurred to her as curious that the note she had received had been written upon extremely fine paper and in a handwriting which revealed breeding and education. yet this peasant's hut suggested neither the one nor the other. but nona was more mystified than fearful since her red cross uniform was her protection, and these were not days when one dared think of oneself. she knocked quietly but firmly on the wooden door. the next moment the heavy bar was slipped aside. then nona saw a woman of about thirty-five, dressed in the costume of a russian peasant, standing with both hands outstretched toward her. "my dear," she began in perfect english, "this is better fortune than i dreamed, to find you once again, and in russia, of all countries!" chapter ii _a former acquaintance_ "but," nona began, and then hesitated, feeling extraordinarily puzzled. the face of the woman before her was oddly familiar, although she could not at the instant recall where or when she had known her. yet she remembered the deep blue-gray eyes with their perfectly penciled dark brows and lashes, even the rather sad expression of them. however, she must be mistaken, since she could have no acquaintance in russia! however, she allowed herself to be quietly led inside the hut, where the door was immediately closed behind her. then the girl followed the woman inside a bare chamber, furnished with only a few chairs and a rough table. in an upper corner hung an ikon, the russian image of the christ. the face of the christ was painted in brilliant colors set inside a brass square and this square enclosed in a dark wooden frame. the ikon is to the russian who is a greek catholic what the crucifix is to the roman catholic. no orthodox russian home is ever without one. but after the first glance, nona davis gave no further consideration to her surroundings. before her companion could speak the second time she had suddenly recognized her. "why, lady dorian, what has brought you to russia? you are the last person i expected to see! since our meeting on board the 'philadelphia' and your stay at the sacred heart hospital i have so often wondered what had become of you, and if you were well and happy. you promised to write me." "then you have not forgotten me?" before saying anything more the older woman found a chair for her guest and another for herself. "no, i have not written you, but i have thought of you many times and have followed your history more closely than you dream," she returned quietly, yet with evident earnestness. "i have been well and i suppose as happy as most people. how can any human being be anything but wretched during this tragic war? if only we might have peace!" lady dorian's face became white and drawn and nona felt that she had aged a great deal since their first meeting, and indeed since the months they had spent as fellow workers for the british soldiers at the sacred heart hospital. nevertheless she still felt strangely attracted toward her companion, although mingled with the attraction was a new and uncomfortable feeling of distrust. lady dorian had come to the hospital cleared of the charge made against her on board the "philadelphia" of being a spy. yet she had never given any explanation of her history. then had followed her surprising meeting with the british officer, colonel dalton, and their betrayal of a former acquaintanceship. although the older woman had promised to explain their connection later, she had only said that they had once known each other rather intimately in london. but as they were friends no longer, she preferred not speaking of him again. all this passed swiftly through nona's mind while the older woman was speaking. but the girl devoutly hoped that her face did not betray her thoughts. for here was the most surprising situation of all! lady dorian had seemed to be a woman of wealth at the beginning of their acquaintance and certainly had given a large sum of money to the sacred heart hospital. now to find her dressed as a peasant and living in a peasant's hut in russia! her skirt was of some cheap black material and her bodice of velveteen, laced with black cords over a white cotton waist. she also wore a russian peasant's apron of brighter colors. yet nona recognized the older woman's beauty and distinction in spite of her costume, even while her present circumstances and her eccentricities antagonized her visitor. the woman was sitting with her level brows drawn together looking closely at the younger girl. "i am sorry you don't seem to feel your former faith in me, nona," she began unexpectedly. "not that i blame you, for i do not know myself whether it is wise for me to have intruded into your life again. i would not have done so if there had not been a reason more important than you can appreciate." for a moment the girl's attention had been wandering, engaged by the oddness of her surroundings, but now she tried to conceal her growing discomfort. lady dorian was appearing more mysterious than ever! if she desired to renew their acquaintance because they had formerly liked each other, that was a sufficient reason for her summons. it was scarcely worth while to try to produce other motives. but lady dorian had gotten up and now stood facing her. "what i am going to tell you is extraordinary, nona, although life is too full of strange happenings to make us wonder at anything. in the first place, will you please cease to call me _lady dorian_, for that is not my name. nor is it remarkable for you to discover me living in russia, because i am a russian by birth. i have not always made my home in my own country, but that makes no difference, since my love and sympathy have always been with my own people. here i am only known as 'sonya.' but i do not wish to speak of myself, but of you. i have a strong reason for my interest in you, nona, for although you may find it hard to believe, i once knew your mother." "knew my mother?" the young american girl scarcely understood what was being said. she was so many thousands of miles both in fact and in thought from her own home and her own history. she could not believe that her companion was telling the truth. in any case she was merely mistaking her for some one else. so nona shook her head gravely. "i am sorry, but i don't think that possible," she explained. "my mother was a southern woman, who lived very quietly in an old-fashioned city. i can't see how your lives could ever have touched." until this instant nona had remained seated with her former friend standing before her. she did not realize how much she showed her resentment at this use of her mother's name. now she made an effort to rise from her chair. "i am very happy to have seen you again," she protested in the formal manner which barbara meade sometimes admired and at other times resented. but her companion was not influenced and indeed paid no attention to the younger girl's hauteur. she merely put a restraining hand on her shoulder, adding, "it is not worth while for us to argue that point until you hear what i have to say. the fact is, i know more of your mother, nona, than you do yourself. for one thing, your mother was also a russian. she was older than i, but we were together at one time in the united states. she went to visit in new orleans and there met your father and married. i knew she had a daughter by your name, but curiously when i first met you on board the steamer your name conveyed nothing to me. perhaps the last thing i expected was to find the daughter of your father, general robert davis, serving as a red cross nurse. he was a conservative of the old school, and i supposed would never have allowed you to leave home. but after we came together again and i met you for the second time at the sacred heart hospital, i began to think of what association i had with your name. soon i remembered and then i endeavored to discover your history. there was a chance that the name had no connection with the girl i sought. but it was simple enough to make the discovery." "simple enough to make the discovery!" stupidly nona davis repeated the words aloud, because they puzzled her. then it occurred to her that the woman before her was so associated with mysteries that a family problem must be comparatively simple. doubtless she had been able to discover more of nona's mother's history than she herself had ever found out. but nona was by no means pleased with the thought of an association between her own people and lady dorian, who had just frankly confessed that this name had been an assumed one. nor did she wish to go into the subject of her family connection with so uncomfortable a stranger. first she wished to have time to think the situation over and to try to make it clearer to her own mind. then she wished to discuss it with mildred and barbara. the girl glanced at the old-fashioned watch belonging to her father, which she always wore. in the back it held her mother's picture, but not for worlds would she have revealed this fact at the moment. curious that she should feel this extreme distrust of her companion, when she had been her ardent defender in their earlier acquaintance! but then she had never expected to be drawn into any intimacy with her. besides, russia was an incomprehensible country. the class distinctions which had so impressed her in england were as nothing to the differences in rank here. russia, in truth, seemed a land of princes and paupers! to a girl of nona davis' ideas and training, to find herself associated with the lower orders of russian society was distinctly disagreeable. she had lived so long on the tradition of family that social position seemed of first importance. now her former acquaintance was living in a peasant's house and was dressed like a peasant woman. some strange change must have taken place in her life to reduce her to such a position, when previously she had given the impression of wealth and distinction. nona got up hurriedly, drawing her coat about her. later perhaps she might be willing to hear what the other woman wished to confide, but not today. yet nona felt that she did not wish to look into her companion's eyes. she must try not to think of her any longer as lady dorian, though "sonya" was an exquisite russian name, it certainly gave no clue to her identity. however, she could not fail to see that the other woman's expression revealed surprise and sorrow at her attitude, but was without resentment. it was as if she had grown accustomed to distrust and coldness. "i am sorry you don't wish me to speak of your mother, nona. it is true i can give you no explanation of the change in my surroundings, but the present need not affect the past. i know that your father has kept your mother's story a secret from you. yet there is nothing in it of which you may not be proud, that is, if you have the nature which i have hoped to find in you." embarrassed and yet determined not to listen any further, nona continued obstinately walking toward the door, with sonya quietly following her. "will you wait a moment, please?" the older woman asked. "i have two friends here in the house with me, whom i would like you to meet. when you talk me over with mildred and barbara to find out their opinion of me and of what i have tried to tell you, you can explain to them that i am not alone. i realize that i have always been a mystifying acquaintance and i'm sorry, but it is not possible to tell you my history at present. some day i may be able to explain." sonya's tone was half grave and half gay. moreover, her blue eyes with their curiously dark brows and lashes watched the younger girl with an almost wistful affection. the situation was more than puzzling. yet, although she grew more anxious each minute to be away, nona could only agree to her companion's request. for a moment she was left alone in the crude, bare room. it was cheerless and cold and she grew even more uncomfortable. surely, russia was the strangest land in the world. how could her history as a young american girl have any connection with it? why had she so insisted upon continuing her red cross nursing in russia, when without her urging the other red cross girls would have been content to remain where they were? the next moment a very old woman and a man came into the room with sonya. there was no doubting they were both peasants. with them it was not merely a matter of rough clothes. they were both heavily built, with stupid, sad faces and they mumbled something in broken english when they were introduced to nona, eyeing her with suspicion. it was only when their gaze rested upon sonya that their faces changed. then it was as though a light had shone through darkness. sonya introduced them by name, some queer russian name which nona could not grasp. however, she was trying her best to find something civil to say in return, which they might be able to understand, when an unexpected noise interrupted them. some one had unceremoniously opened the door in the hall and was walking toward them. for an instant nona thought she saw a shade of anxiety cross the faces of her three companions, but the next instant it was gone. nona could scarcely swallow a gasp of surprised admiration when, soon after, the door opened. a young russian soldier entered the room. he wore the uniform of a cossack: the high boots, the fur cap and tunic. to nona davis' american eyes the young man seemed a typical russian of the better classes. he was extremely handsome, more than six feet tall, with dark hair and eyes and a colorless skin. he appeared surprised at nona's presence, but explained that he was stationed at the russian fort where a number of wounded were being cared for. he remembered having seen nona and her two friends. they were the only american nurses in the vicinity, so it was not strange to have noticed them. michael orlaff was the soldier's name. sonya spoke it with distinctness, but gave him no title. yet evidently they knew each other very well. a moment later and nona finally got away. she was late and nervous about returning to the fortifications alone. yet as she hurried on she was thinking over the afternoon until her head ached with the mystery of it. perhaps it might be wise if she could avoid meeting this particular group of people again. chapter iii _general alexis_ all that day mildred thornton had scarcely left the bedside of her patient. for the russian boy was dying, and as there was no hope for him, mildred could only do her best to make him as comfortable as possible. now he seemed half asleep, so with her hands folded in her lap the girl sat near him trying to rest, although unable to keep her mind as quiet as her hands. how strange her surroundings! since her arrival in europe as a red cross nurse she had lived and worked in two other countries and certainly had passed through remarkable experiences, yet none of them were to be compared with these few weeks of nursing in russia. one might have been transferred to another planet instead of another land. as an ordinary american tourist, mildred had been familiar with europe for several years, having spent three summers abroad traveling with her parents. but this was her first vision of the east, for russia is eastern, however she may count herself otherwise. the american girl now lifted her eyes from the figure of the dying boy and let them wander down the length of the room which sheltered them. an immense place, it held rows on rows of other cot beds with white-clad nurses passing about among them. when they spoke or when the patients spoke mildred could rarely guess what was being said, as she knew so few words of russian. yet she had little difficulty with her nursing, for the ways of the ill are universal and she had already seen so much suffering. now the hospital room was in half shadow, but it was never light nor aired as the american nurse felt it should be. the hospital quarters were only a portion of the fortress, a great room, like a barracks which had been hastily turned into a refuge for the wounded. the long stone chamber boasted only four small windows hardly larger than portholes and some distance from the ground. these opened with difficulty and were protected by heavy iron bars. but then in russia in many private houses no window is ever voluntarily opened from autumn until easter, as the cold is so intense and the arrangements for heating so crude. today mildred wondered if the heavy, sick-laden air was giving her extraordinary fancies. she kept seeing dream pictures. for as she stared about the cold chamber of sorrow she beheld with greater distinctness the image of her own rooms at home. this was the hour when the maid came to light her yellow-shaded electric candles; then she would put a fresh log on the fire and stir it to brightness, not because the added warmth was needed in their big steam-heated house, but because of the cheerfulness. then would follow her mother's invitation to drink a cup of tea with her and dick in the library, or would she prefer having it served in her own room? with this thought the girl's eyes clouded for a moment. doubtless dick and her mother would be having tea together this afternoon and dick would in all probability be trying to explain why his sister was not with him. during her work in france and belgium her mother and father had been more than kind, but with this suggestion of coming into russia to continue her nursing both her parents had protested. it is true that they had not actually demanded her presence at home, for she would not have disobeyed a command. but undoubtedly they had urged her homecoming. her father longed for her because of the rare affection between them and the fact that he dreaded the conditions and experiences that might await her and her friends in russia. for these same reasons her mother also desired her return, yet mildred knew that there was another motive actuating her mother. she might be unconscious of the fact, but if her daughter should reappear in new york society at the present time, because of her war experiences she would become an object of unusual interest and attention. at this instant the smile that appeared at the corners of the girl's mouth banished the tired expression it had previously worn. one big thing her war experiences had done for mildred thornton, it had given her a new sense of values. now she _knew_ the things that counted. she had learned to smile at her own failure as a society girl, even to understand and forgive her mother's chagrin at the fact. yet mildred was influenced in a measure to continue her work in europe by these trivial points of view. should she return home and re-enter society as her mother wished, sooner or later she must prove a second disappointment. for she had no social gifts; she could never learn to talk as her friends did. if questions were asked of her she could only reply with facts, not because she was lacking in sympathy or imagination, but because she had not the grace of words. so with neither beauty nor charm, how could she ever even hope to gratify her mother by securing the distinguished husband she so desired for her? but since there was a place in the world for bees as well as butterflies, mildred never meant to allow herself to grow unhappy again. she had a real talent for nursing; her work had received only praise. so here in europe, where there seemed to be the greatest need of her services, she meant to remain as long as possible. this, in spite of the alluring picture of home which would thrust itself before her consciousness. at this instant the boy on the bed moved and sighed and at the same instant the american girl forgot herself. he had opened his eyes and mildred could see that he had become dimly conscious of his own condition and his surroundings. but this boy could never have been more than dimly conscious of most things in his short life, he was so stupid and could neither read nor write; indeed, he had a vocabulary of but a few hundred words. peter had been a laborer on the estates of a polish nobleman when the call came to arms. and so often in the past week while she had been caring for him mildred had been reminded of some farm animal by the way the boy endured pain, he had been so dumb and uncomplaining. even now he made no attempt to speak, but as she leaned over and took his hand mildred realized that the boy could live but a few moments longer. after a little tender smoothing of his cover the girl turned away. the russian peasant is always a devout catholic, so mildred realized that he would wish a priest with him at the end. she had walked only a few feet from the young soldier's bedside when an unaccustomed atmosphere of excitement in the ward arrested her attention. it would not be necessary for her to summon a priest; some one must have anticipated her desire. for the priest was even now approaching. however, he was a familiar figure, passing hourly among the wounded and their attendants; his presence would cause no excitement. the next instant mildred understood the priest was not alone. he was accompanied by one of the most famous men in all europe. although she had never seen him until this instant, mildred thornton had not a moment's doubt of the man's identity. this was the commander of the fortress at grovno, general dmitri alexis, at the present hour the bulwark of many russian hopes. for the past few weeks the germans had been driving the russians farther and farther back beyond the boundaries of poland and near the heart of russia. here at grovno the russian army was expected to make a victorious stand. the faith of the russian people was centered in general dmitri alexis. unlike most russian officers, he had always been devoted to the interests of the common people, although a son of one of russia's noble families. but he was known to be a shy, quiet man with little to say for himself, who had risen to his present rank by sheer ability. to mildred's eyes he seemed almost an old man; in fact, he must have been about fifty. his hair was iron gray, but unlike most russians his eyes were a dark blue. as he wore no beard, the lines about his mouth were so stern as to be almost forbidding. mildred knew that he was an intimate personal friend of the czar and realized just to what extent he must feel the weight of his present responsibilities. therefore she was the more surprised at his appearance in the hospital ward. except for a courtly inclination of his head the great man paid no attention to the greetings that were offered him by the nurses and doctors. walking down the center of the room he had eyes only for the wounded men who lined the two walls. then his sternness relaxed and his smile became a curious compound of pity and regret. mildred found herself staring without regard to good manners or breeding. why should this man create such an atmosphere of trust and respect? she had seen other great generals in the armies of the allies before today, but never one who had made such an impression. general alexis and the priest paused by the bedside of the russian boy who was mildred's patient. there the great man's face softened until it became almost womanish in its sympathy. slowly and reverently the dying boy attempted to raise his general's hand to his lips. general alexis said a few words in russian which the young soldier understood, but mildred could not. for he attempted to shake his head, to whisper a denial, then smiling dropped his arms down by his sides. mildred made no effort to move forward to assist him, for she did not feel that she had a place in the little group at this moment. she merely watched and waited, trying to see clearly through the mist in her eyes. the boy's broad chest, strong once as a young giant's, but now with a scarcely beating heart beneath it, quivered with what seemed a final emotion. the same instant general alexis leaned down and pinned against the white cotton of his rough shirt the iron cross of all the russias. afterwards he kissed him as simply as a woman might have done. that was all! so natural and so quiet it was, mildred thornton herself was hardly aware of the significance of the little scene she had just witnessed. here in a country where the gulf between the rich and the poor, the humble and the great was well nigh impassable, a single act of courage had bridged it. what act of valor peter had performed mildred never knew. she only knew that it had called from his duties one of the greatest men in europe, that he might by his presence and with his own hands show homage to the humblest of soldiers. when the simple ceremony was over the boy lay quite still, scarcely noticing that his general knelt down beside his bed. for his eyes were almost closing. neither did mildred dare move or speak. against the walls the other nurses and doctors stood quiet as wooden figures, while the wounded were hushed to unaccustomed silences. then the russian priest began to intone in words which the american girl could not understand, but in a voice the most wonderful she had ever heard. his tones were those of an organ deep and beautiful, of great volume but without noise. ceasing, he lifted an ikon before the young soldier's dimming eyes, and pronounced what must have been a benediction. the next moment the great stillness had entered the hospital chamber and the russian boy with the iron cross above his heart lay in his final sleep. all at once mildred thornton felt extraordinarily weary. backward and forward she could see the big room rise and recede as though it had been an immense wave. the dim light was turning to darkness, when instinctively reaching out her hand touched the back of a chair. with this she steadied herself for the moment. until now she had not known how tired she was from her vigil, nor how she had been moved by the scene she had just witnessed. after a little she would go to her own room and perhaps nona or barbara would be there. but she must wait until general alexis and the priest had gone away. the next moment she realized that the great man had risen and was approaching toward her. mildred looked wholly unlike a russian woman. her heavy flaxen hair, simply braided and twisted about her head, showed a few strands underneath her nurse's cap. her face was almost colorless, yet her pallor was unlike the russian, which is of a strange olive tone. now and then in her nurse's costume mildred thornton became almost beautiful, through her air of strength and refinement and the unusual sweetness of her expression. the eyes that were turned toward general alexis were a clear blue-gray, but there were deep circles under them, and the girl swayed a little in spite of her effort to stand perfectly still. for several seconds the great man regarded her in silence. then he stretched forth his hand. "you are an american red cross nurse, i believe. may i have the honor of shaking your hand. i have been told that three young american women are here at our fortress at grovno helping to care for our wounded. you have traveled many miles for a noble cause. in the name of my emperor and his people may i thank you." the little speech was made in perfect english and with such simplicity that mildred did not feel awed or surprised. however, she was not certain how she replied or if she replied at all. she only felt her cold fingers held in a hand like steel and the next moment the great general had gone out of the room. immediately after mildred found herself surrounded by a group of russian nurses. the russians are amazing linguists and several of the nurses could speak english. evidently they were overwhelmed by the honor the american girl had just had bestowed upon her. it had almost overshadowed for the time the greater glory of the young soldier. an american red cross nurse had been individually thanked by one of the greatest commanders in europe for her service and the services of her friends to his soldiers and his country. but there was another personal side to the situation which the russian hospital staff appeared to find more amazing. general dmitri alexis was supposed never to speak to a woman. he was an old bachelor and was said to greatly despise the frivolities of russian society women. incredible as it may seem, there is gossip even inside a great fortress in time of war. but mildred's russian companions had neither time nor opportunity to reveal much to her at present. as soon as it was possible she begged that she might be allowed to go to her own room. although she shared it with nona and barbara, neither one of them was there at the time. but instead of lying down at once mildred wrote a few lines to her mother. she knew that she would be greatly pleased by the attention that had just been paid her. of course mildred realized that the general's thanks were not bestowed upon her as an individual, but as a representative of the united states, whose sympathy and friendliness russia so greatly appreciated. chapter iv _an encounter_ barbara had been writing a letter to dick thornton. she was seated on the side of her cot bed in a tiny room high up in a tower, with only one small window overlooking the courtyard below. although it was well into the twentieth century, this room was just such an one as might have concealed the hapless amy robsart in the days of lord leicester and kenilworth castle. but although barbara had not to suffer the thought of a faithless lover, at the present moment she was feeling extremely sorry for herself. russia had no charms for her as it appeared to have for mildred thornton and nona davis. she disliked its bleakness, its barbarity and the strange, moody people it contained. of course she realized that there was another side to russian life, before the present war its society was one of the gayest in the world. but these days, when the germans were driving the russian army backward and even further backward behind their own frontiers, were days for work and silence, not social amusements. moreover, barbara knew that she could never expect to have any part in russian social life when her mission lay among the wounded. so far she had met only other red cross nurses, a few physicians and the soldiers who required her care. but really barbara was not so foolish as to resent these conditions; she was merely homesick and anxious to see dick thornton, and if not dick, then eugenia. france had not seemed so far away from the united states and she had loved france and its brave, gay people. she had understood them and their life. almost she had envied eugenia her future possession of the old chateau and the little "farmhouse with the blue front door." but then eugenia had seemed to find france as strange and uncongenial as barbara now considered russia. even after her marriage to captain castaigne, eugenia had confessed to the younger girl how she dreaded her own inability to become a frenchwoman. she still feared that she would never be equal to the things captain castaigne had a right to expect of her, once the war was over. eugenia had merely cared too much to be willing to give him up, but was too wise to expect that her problems would end with marriage. so with this thought barbara meade finally removed a tear from the end of her nose. it had trickled quite comfortably out of her eyes, but as her nose was somewhat retroussé, it had hesitated there. after all, an american marriage was best for an american girl! barbara tried to convince herself that she should be rejoicing instead of lamenting. certainly dick was the most agreeable and to be desired person in the entire world. but then there was another side to this! had he not been, perhaps she would not at this moment be missing him so terribly and at all the moments. letters were so infrequent! mrs. thornton might positively refuse to allow her son to marry so insignificant a person, and dick forget all about her! but in the midst of this last and most harrowing thought, fortunately nona davis came into the room. she looked excited, but on catching sight of her friend's face her expression changed. "good heavens, barbara!" she began. then the next moment she walked over and tilted the other girl's chin with her hand. "you are just homesick, aren't you, and longing for some one who shall be nameless? you frightened me at first; i feared you had heard dreadful news. come, get your coat and have a walk with me. we have both nearly two hours of freedom and i've permission to go outside the fortifications." the other girl shook her head and shivered. "it is too cold, nona dear, and besides, i'm afraid. i know the russians are said to be holding the line of fortifications beyond us, but then the germans may break through at any time. goodness knows, i don't see what you and mildred find so fascinating in russia! i am afraid i am not brave enough to have come with you." while barbara was arguing nona had taken her coat from its hook on the wall and was putting it about her friend. "yes, i know all that, but just the same you are coming for a walk. as long as you are here you must keep strong enough to do your work. but there, i can't scold half so well as eugenia. i suppose if dick belonged to me i should be as wretched as you are without him. you are a dear to have stuck by mildred and me during this russian work. but do come, i've something really interesting to tell you. perhaps you may feel a tiny bit less lonely afterwards." in the meantime nona had put on her own coat and cap and the two girls started. they had to walk down a narrow stone corridor and then a long flight of winding stone steps to reach the courtyard below. to the right the soldiers were drilling. one could hear the harsh clatter of their heavy boots and the crash of their rifles when they touched the frozen earth. it had turned unexpectedly cold, and yet without a spoken word both girls stopped and stared about them as soon as they reached the outdoors. certainly the scene formed an extraordinary setting for two young american girls! the sky was gray, and although it was only early autumn, there were occasional flurries of snow. behind them stood a long, low line of stone and iron fortifications with enormous guns mounted at intervals along the walls. at one end was an observation tower, where one could see miles on miles of trenches stretching in a kind of semicircle before the fortifications. should the enemy destroy the trenches the russian soldiers could then mass behind the fort and afterwards, if necessary, accomplish their retreat. for a small force could delay the enemy through the strength of their position and the use of their big guns. sheltered behind breastworks of earth, barbed wire entanglements and a natural protection of trees, the girls could barely discern the aerodrome. in this place were situated the machine shops for building and repairing aeroplanes, and also from here their flights and returns could be made. yet in spite of these signs of active warfare, the place was curiously silent. barbara felt puzzled. only the endless tramp, tramp of the soldiers at drill and an occasional guttural command. the noises from the inside of the fort never penetrated to the outside. but then these russians were a quiet people. within a few moments the two girls showed their order to the sentry and were allowed to pass beyond the gate. they then started on their walk along the same road which nona had traveled alone several days before. but actually this was the first chance the girls had for talking over nona's experiences together. true, they shared the same bedroom, so that on her return nona had given a brief report. but really they had been too tired at night to grasp the situation. now naturally barbara thought her companion meant to talk of her recent experience. neither one of them attempted conversation at the beginning of their walk, for the main road was as filled with supplies of every kind that were being hauled to the great fort, as it had been on the day of nona's solitary excursion. but indeed this was a daily occurrence. so, as soon as possible, the girls got away from the road into a lane that was lined with peasants' huts. this lay in an opposite direction from the path nona had previously taken. she had no desire to meet her former acquaintance again until she had made up her mind as to her own attitude toward her. neither barbara nor mildred had so far been able to give her any definite advice. mildred really refused to consider that the older woman could have known nona's mother years before in their own country. her story was too incredible to be believed. barbara had not taken this same point of view. at the present moment she was going over the situation in retrospection. in the first place, it was absurd to think that any train of circumstances could be impossible in such a surprising world. the woman, whom they had once known as lady dorian and whom they now were to think of by another name, had evidently once been a woman of wealth and culture, no matter what her present condition of poverty. she seemed to have traveled everywhere and she may of course have met nona davis' family. there was actually no reason why she should not have known them, barbara concluded in her sensible western fashion. doubtless when nona allowed the older woman to explain the situation it would not be half so mysterious as it now appeared. the really remarkable thing was, not that the other woman should be familiar with nona's mother's history, but that her own daughter should be so in ignorance. for her part she intended to advise nona to listen to whatever their former friend wished to tell her. but just as barbara opened her lips to offer this advice, her companion spoke. "barbara, you have been in such a study you haven't asked for the piece of news i have to give you. do you remember almost quarreling with me because i did not wish to write a note to the english fellow we once knew when we were in brussels, after you discovered him in prison there?" barbara nodded, her mind immediately distracted from her former train of thought. "lieutenant hume? why, do you know what has become of him?" she inquired. in reply nona took a letter out of her pocket. "i had a note from him today. you see, after your lecture i continued writing him in prison every now and then during the year we spent in belgium. just occasionally he was allowed to send me a few lines in reply. then a long time passed and i had almost forgotten him. now he writes to say that by an extraordinary freak of fortune he has been returned home. it seems that he became very ill, so when the germans decided to agree on an exchange of prisoners, he and our little blind frenchman, monsieur bebé, were both sent back to their own lands. lieutenant hume does not say what is the matter with him. his letter isn't about himself. he is really tremendously anxious to hear news of us. he has just learned of eugenia's marriage to henri castaigne, and he thinks we are pretty foolhardy to have offered our services for nursing in russia." instinctively barbara held her companion's arm in a closer grasp. "far be it from me to disagree with him!" she murmured. for her attention had just been arrested by the noise of a horse's hoofs approaching. both girls looked up to see a young cossack soldier riding toward them. he sat his horse as though he were a part of it, his feet swinging in long stirrups and his hands barely touching the reins. both girls felt a stirring sense of admiration. but to their surprise, as the horse drew near the young soldier pulled up and slid quietly to the ground. the next instant he came up toward nona. "you will pardon me," he said, speaking english, although with a noticeable accent, "but it will not be wise for you to continue to walk any further along this road. it is growing late and there are stragglers coming in from several villages where a german raid is feared." he had taken off his pointed cossack cap of lamb's wool and held it in his hand as though he had been a young american meeting a group of friends upon an ordinary thoroughfare. barbara was struck by the incongruity of his appearance and his behavior. he looked like a half-civilized warrior of centuries ago, and yet his manner was the conventional one of today. however, it would not be wise to expect him to remain conventional under unusual conditions. barbara could see that the young russian officer was a son of the east, not the west. he had a peculiar oriental pallor and long, slanting dark eyes, and his small black moustache scarcely concealed the thin red lines of his lips. nona was frowning at him in a puzzled fashion. but the next instant she bowed with an expression of recognition. "thank you, we will do as you suggest. it is odd to see you so soon again after our unexpected meeting the other afternoon. lieutenant orlaff, this is my friend, miss meade." barbara inclined her head, too surprised to do more. but as the russian officer continued to walk beside them with his horse following, she soon understood where he and nona had met each other. "yes, she is an old friend, sonya valesky. i knew her years ago and then she went away into other countries." the young russian hesitated. barbara and nona were both watching his face closely, so that they could see the cloud of doubt, even of struggle, that swept over it. "you are strangers in my country, but you have come here to help us in our need," he protested, almost as if he were thinking aloud. "i would not have you doubt my friend. i cannot explain to you, and yet i wish to warn you. do not be too intimate with sonya valesky. russia is not like other countries in times of war or peace. she has many problems, tragedies of her own to overcome which the foreigner cannot understand. forgive me if i should not have spoken." then before either girl could fully grasp what the young man's confused speech could mean, he had bowed, mounted his horse and ridden off. chapter v _out of the past_ but circumstances afterwards made it impossible for nona davis to follow the young russian officer's advice. a week went by at the hospital without a decision on the girl's part and without another word from her former friend. sonya valesky she must remember was her russian name. a beautiful name and somehow it seemed to fit the personality of the woman whom nona at once admired and distrusted. for the name carried with it its own suggestion of beauty and of melancholy. what secret could sonya valesky be concealing that forced even her friends to warn others against her? of course there could be no answer in her own consciousness to this puzzle, yet nona kept the problem at the back of her mind during the following week of strenuous work. nursing inside the bleak fortress at grovno was of a more difficult character than any work the three american red cross girls had yet undertaken. the surroundings were so uncomfortable, the nursing supplies so limited. worse than anything else, an atmosphere of almost tragic suspense hung like a palpable cloud over every inmate of the fort. authentic news was difficult to obtain, yet refugees were constantly pouring in with stories of fresh german conquests in poland. for it chanced that the months after the arrival of the three american girls in russia were among the darkest in russia's history during the great war. military strategists might be able to understand why the grand duke nicholas and his army were giving way before almost every furious german onslaught. they could explain that he was endeavoring to lead the enemy deeper and deeper into a foreign land, so as to cut them off from their base of supplies. yet it was hard for the ordinary man and woman or the common soldier to conceive of anything except fresh danger and disaster in each defeat. so day after day, night after night the business of strengthening the line of fortifications at grovno went on. the work was done with the silence and the industry of some enormous horde of ants. shut off in the left wing of the fort with the ill and wounded soldiers, the red cross nurses had only occasional glimpses of the warlike preparations that were being made. once when there was a review of the troops in the courtyard behind the fortifications mildred thornton summoned nona and barbara. she had already told them of her experience with the commanding officer of the fort, but she wished the other two girls to have a look at him. it was difficult to get a vivid impression of a personality from a bird's-eye view out of a small upper window. yet the figure of general alexis could never be anything but dominating. there was a hush of admiration from every man or woman inside the fortifications whenever their leader's name was mentioned. if he could not hold the german avalanche in check, then the world must weep for russia. so mildred became a kind of heroine among the nurses because she had received a few moments of the great man's praise and attention. finally, at the end of a week nona davis had a second letter from sonya valesky. it was sent by a messenger, as the other had been, and nona was presented with it when she first went on duty on one saturday morning. this communication was not merely a note, however, for the envelope was sealed and had a bulky appearance. yet nona did not open it all that day or the morning of the next as she had a premonition that the letter was not an ordinary one. either madame valesky was confiding her own history, or she was insisting upon proving to the american girl that she had at one time been a friend of her mother's. really, it was this information that nona both expected and feared. so as she had a particularly difficult case on hand she decided to wait for more leisure before trying to solve the mystery. the opportunity came when she was allowed two hours rest on sunday afternoon. nona was glad that both mildred and barbara were busy at the time, because she preferred to be alone. after her letter had been read and considered then she could decide on the degree of her confidences. but after all, barbara's prediction came true. the story that sonya valesky had to tell of her acquaintance with nona's mother was not half so strange as the fact that the mother's history had been concealed from her daughter. the story was unique but comparatively simple. the only curious fact was the accidental meeting between the russian woman and the american girl. but then just such comings together of persons with a common bond of interest or affection is an hourly occurrence in the world. behind such apparent accidents is some law of nature, a like calling unto like. the older woman explained that she had known nona's mother many years ago when they were both children in russia, although she was a number of years younger. there was as little as possible of sonya valesky's own history in the letter. she stated without proof or comment that her father had once been russian ambassador to the united states. here anna orlaff, nona's mother, had made her a visit and had then gone away south to new orleans and soon afterwards married. for many years the younger girl had not seen her friend again. she had received letters from her, however, and learned that her marriage was not a success. sonya valesky did her best to explain the situation to nona. but how was she to know how much or how little an american girl understands of life and conditions in russia? was nona aware that there were many girls and young men, oftentimes members of noble families, who believed in a new and different russia? had nona ever read of a great writer named tolstoi, who wrote and preached of the real brotherhood of man? he insisted that the words of christ should be interpreted literally and desired that russia, and indeed the world, should have no rich and poor, no czar and slave, but that all men and all women were to be truly equal. nona's mother had been a follower of tolstoi's principles; therefore, her people had sent her away from her own country because they feared if she continued to live in russia with these ideas she might be condemned to siberia. so anna orlaff had gladly left her own country, believing that in the united states she would find the spirit of true equality. naturally her marriage had been a disappointment. at this point in sonya valesky's letter, nona davis began to have a faint appreciation of the situation. she remembered the narrow, conservative life of the old south and that her father had lived largely upon traditions of wealth and family, teaching her little else. what did it matter to him that there were no titles in america, no more slaves to do his bidding, when he continued to believe in the domination of one class over another. dimly at first, more vividly afterwards, nona davis could see the picture of the young russian girl, a socialist and dreamer, married into such an environment. how disappointed and unhappy she must have been in the conservative old city of charleston, south carolina! no wonder people had never mentioned her name to her daughter, and that her father had been so silent! a russian socialist was little less than a criminal. nona was seated in a hard wooden chair in a small, cell-like room many thousands of miles away from her own old home. certainly something stronger than her own wish must have drawn her to russia, for here she must learn to understand the story of her mother's life and to find her own place in it. at this point in the narrative nona let her letter fall idly in her lap. the girl's hands were clasped tightly together, for now her imagination could tell her more than any words of another's. her father had been devoted to her, but he had not been fair, neither had his friends nor her own. why had they always led her to believe by their silences that there was something to be ashamed of in her mother's story? it was odd, of course, to be different from other people, but there was no sin in being a dreamer. nona could see the picture of her mother in the white muslin dress and the blue sash there in their old drawing room in charleston. she had been only a girl of about her age when she remembered her. but then what had become of her mother? why had she gone away? again the girl picked up her letter, for the last few sheets must explain. this portion was hardest of the story to understand, but sonya valesky had tried to make it clear. nona's father had insisted that his young wife give up her views of life. she was to read no books, write no letters, have nothing to do with any human being who thought as she did. above all, she was to make him a written and sacred promise that she would never reveal her ideas of life to her daughter. this nona's mother had refused to do and so had gone away, expecting to come back some day when her husband relented. within a year she had died. but here sonya valesky's letter ended, for she enclosed another written by nona's mother to her friend. if nona had needed proof of the truth of the other woman's statement she could find it here. the letter was yellow with age and very short. it merely asked that if sonya valesky should ever find it possible to know her daughter, nona davis, would she be her friend? then sonya had also enclosed another proof, if proof were needed. this was a small picture of nona's mother which was exactly like the one the girl had found concealed in the back of her father's watch. it was the same watch with the same picture that she now wore always inside her dress. then for nearly an hour the young american girl sat dreaming almost without a movement of her body. little by little she recalled stray memories in her life which made her mother's history appear not so impossible as she had at first conceived. always she had thought of her as foreign. she had only believed her to be french because she spoke french so perfectly and had married in new orleans. but then she herself was beginning to learn that educated russians are among the most accomplished linguists in the world. what else was she to find out about this strange country before her work as a nurse was over? could she ever feel so entirely an american again? all at once nona davis jumped hastily to her feet. there were hundreds of questions she yearned to ask. fortunately for her she was near the one person who might be able to answer them. sonya valesky had never said why she had not sought to find her friend's daughter until their accidental meeting on shipboard. even then she had not recognized nona's connection with the past. was it because she was too engrossed in her own life and her own mysterious mission? although she was at this instant engaged in putting on her coat and cap to go to her, nona again hesitated. how little the russian woman had said of herself! what was she doing here near the russian line of fortifications, living like a peasant with only two old peasants in attendance upon her? and why should the young russian officer have warned her against his own friend? "michael orlaff." automatically nona davis repeated the name of her new acquaintance. "orlaff." the name was the same as her mother's. was there a chance that the young russian lieutenant might be a possible connection? however, the girl recognized that she was stupid to continue to ask herself questions. moreover, she had now made up her mind that she must not distrust sonya valesky unless she had a more definite cause. doubtless sonya shared the same views of life that her mother had cherished! but in any case it was wonderful to have found a woman who had been her mother's friend and who might still be hers. nona had walked across her small room to the door, when she heard some one knocking. a summons had been sent for her to return to her nursing, as the two hours of her recreation were over. how stupid she had been! actually nona had forgotten what had called her to russia, even the war tragedy that was raging about her. of course she could not leave the hospital! it might be several days or more before she could hope to receive permission to revisit sonya. chapter vi _the arrest_ five days later nona davis went again to the little wooden house, where, to her surprise, she had previously discovered a former acquaintance. but on this occasion sonya valesky did not open the door. instead it was opened by the old peasant man whom nona had seen before. today he looked more wretched than stupid. his little black eyes were red rimmed, his sallow skin more wrinkled than ever. when nona inquired for sonya he shook his head disconsolately and then motioned her toward the same room she had formerly entered. there was now a cot in the room and on this cot lay the russian woman. at once nona forgot herself and her desire to ask questions. she remembered only her profession, yes, and one other thing. she recalled the words that the old french peasant, françois, had once spoken to her and to barbara. "have you pity only for wounded soldiers? do girls and women never care to help one another? this war has made wounds deeper than any bullets can create." immediately nona had seen that sonya valesky was very ill. now, no matter who she was, or what she had done, she must be restored to health. first and last nona must put her own emotions aside, for the sake of her mission as a red cross nurse. yet what was she to do? her services belonged to the soldiers in the russian fortress. as quietly and quickly as possible nona gave her orders. she could not be sure, but sonya's appearance indicated that she was suffering from the terrible scourge of typhus. this disease had been one of the most terrible results of the war. because of a greater lack of sanitation and cleanliness the fever had been more widespread in servia and in russia than in any other countries. personally nona had never nursed a case before, yet she had heard the disease discussed and believed she recognized the symptoms. first she made a thorough examination of the little house. it was cleaner than most of the peasants' huts, so far sonya must have prevailed, but still its conditions left much to be desired. without being able to speak more than a few words of their language, nona yet managed to give her directions. she was beginning to guess that the old peasant couple, who at first had seemed mysterious companions for the beautiful russian woman, were probably old servants. if sonya was a follower of tolstoi as her mother had been, she must have refused to recognize any difference between them. but this was not their feeling. the american girl could see that in spirit old katja and nika were the devoted slaves of the younger woman. sonya was not at first conscious of the seriousness of her illness. she wore a dressing gown of some rough homespun, a curious shade of russian blue, the color of her own eyes. her hair, which had turned far whiter in the past year, was partly concealed under a small lace cap such as the russian peasant woman often wears. then, although she did not seem able to talk, she knew nona and thanked her for coming and for the advice she was giving the two old people. but when nona had finished with her orders she came and sat down near sonya. "i have read your letter and i have not been able to answer it until now. it seems like a miracle that i should have found out about my own mother here in a strange land. but perhaps i was meant to take care of you. you must promise to do what i tell you. i must go away now, but i'll come back in a little while." nona was getting up when sonya took hold of her skirt. her face was flushed and her dark blue eyes shining. "you must not stay in this house, not for long at a time," she pleaded. "i cannot explain to you why not, but perhaps when i am strong again i can tell you enough to have you guess the rest. now you must go." sonya took nona's cool hands in her hot ones and held them close for a moment. the next moment the american girl had gone. at the hospital inside the fortress she explained the situation, at least so far as it could be explained. a russian woman, who had once been her friend, lay seriously ill at one of the nearby huts. would one of the hospital physicians come and see her? also would it be possible for her to be spared from caring for the soldiers to look after her woman friend? certainly a russian doctor would attend the case; moreover, after certain formalities nona was allowed a leave of absence from the hospital demands. then began an experience for the young american girl that nothing in her past two or more years of nursing had equaled. she was living and working in a new world, amid surroundings which she could not understand and of which she was afraid. the little hut was crude and lonely. the two old peasants could speak no english, but went about their tasks day after day mute and dolorous. sonya was too ill to recognize her nurse, and nona could not allow barbara or mildred to come near her, since her patient's illness was of the most contagious nature. naturally barbara and mildred wholly disapproved of the risk nona was running and she had not time nor strength to make them see her side of the situation. she had written them that sonya valesky had proved herself to have been an old friend of her mother's. for that reason and for several others she felt it her duty to care for her. but strangest of all nona's experiences were the fragments of conversation which she heard from the lips of her ill friend. sonya sometimes spoke of her girlhood and then again of her life in the united states and in england. once or twice she even called the name of captain dalton. nona supposed that she must be recalling her meeting with captain dalton at the sacred heart hospital. then she remembered that sonya had spoken of knowing the english officer years before. but although her patient betrayed many facts of her past life to her nurse, never once did sonya explain why she was living in such an out-of-the-way place. neither did she give any clue to the kind of work that must have engaged her time and energy. surely sonya valesky must have been upon some secret mission in the days of their first meeting on board the "philadelphia!" even then she had papers in her possession which she would allow no one to see. however, sonya was too desperately ill to permit her nurse much opportunity for surmising. nona would never have left her alone for a moment except that she knew it was her duty to keep up her own strength. every afternoon she went for a short walk. and because no one but the russian physician was allowed to enter the house, now and then the young russian lieutenant would join nona along the road. this could only occur when he was able to get leave, yet nona began to hope for his coming. she was so depressed and lonely. once she asked him if he had ever heard of a member of his family named "anna orlaff." of course she gave no reason for her question. but it made no difference, because the young soldier could recall no such person. in the course of one of their talks, however, he confided to nona that he was a younger brother, but that his family were members of the russian nobility. never once, however, did the young man betray any fact connected with sonya valesky's history. he explained that their families had long known each other and that he had always been fond of her, nothing more. so for this reason as well as others nona found herself attracted by the young russian officer. he seemed very simple, much younger than an american of the same age. at this time michael orlaff must have been about twenty-three. but nona was wise enough to discover that he was not so simple and direct as she had first believed him. a russian does not readily betray either his deeper thoughts or his deeper feelings. the young russian lieutenant would not even speak of the war nor his own part in it. yet nona guessed from her own observation and from certain unconscious information that he was one of the favorite younger officers of the russian general in command of the grovno fortifications. so a number of weeks passed, until now and then nona davis almost forgot the war and her original reasons for being in her present strange position. no one brought her papers; barbara's and mildred's letters contained little war news. the truth was possibly being concealed from them, or else there was no way of their discovering it. so nona was at least spared the anxiety of knowing that the victorious german hosts were drawing nearer and nearer the fortress of grovno. like stone houses built by children the other ancient russian forts had fallen before his "excellenz von beseler," the victor of antwerp, who was known as the german battering ram. even when sonya opened her eyes, after weeks of an almost fatal illness, and asked for news of the war, nona was unable to tell her. then as the days of sonya's convalescence went by she would not let her talk of it. always war is a more terrible thing to girls and women than it is to boys and men. but ever since their first acquaintance nona had realized that the horror of it went deeper into sonya's consciousness than any person she had yet seen. it must be the war that had aged her so in the past year. so the russian woman and the american girl spoke of everything else. sonya told of her own life and of nona's mother when they were little girls. they had both been allowed to go away to college. it was in school that they imbibed their revolutionary ideas. no wonder that their families never forgave them! sonya was dressed and sitting in her chair the day when the summons finally came for her arrest. it was nona davis in her nurse's red cross costume who opened the door for the two men in uniform. they were not dressed like soldiers, and as she could not understand what they said, she did not dream of their errand. but sonya's peasant servants must have understood, for at the sight of the strangers they dropped on their knees and held out imploring hands. sonya herself finally made things clear. the men were two police officers who had been sent to bring her to petrograd. she had been in hiding here near grovno for several months and had hoped to escape their vigilance. evidently sonya had been arrested by the russian authorities. in spite of nona's insistence that her patient was not well enough to be moved, sonya agreed to go with them at once. and only at the moment of parting did she bestow any confidence upon the younger girl. then she looked deep into nona's golden brown eyes with her own strangely glowing blue ones, and whispered: "i have done nothing of which i am ashamed, nona, or i should never have asked for your friendship. it may be that i can make the russian people understand, but i do not feel sure. this war has made men blinder than ever. i have only tried to be a follower of the 'prince of peace.'" then after she had walked away a few steps she came back again. "go back to your united states as soon as you can, nona," she urged. "russia is no place for you or your friends." because nona davis dared not trust herself to speak, sonya afterwards went away without a word of faith or farewell from her. chapter vii _a russian church_ one afternoon, after nona had been nursing her friend, sonya valesky, for some time, mildred thornton went alone into a little russian church. the church was situated behind the line of the fortifications at grovno. many years before it had been erected, and now it did not occur to the russian officers that it stood in especial peril. yet the church had the golden dome of all russian churches, glittering like a ball of fire in the sun. certainly it afforded an easy target for the enemy's guns, and more than this would aid german aeroplanists in making observations of the geography of the surrounding neighborhood. but since grovno was deemed invincible, apparently no one considered the possibility of the other side to this question. high cement walls guarded and mounted with cannon encircled the countryside for many miles, while running out from the fortress itself were numerous secret passages and cells, at present stored with ammunition. on this afternoon of mildred's visit to the church she stood outside for a few moments looking upward. at first she was merely admiring the beauty of the little church. the gold of the dome seemed to be the one appealing spot of color in all the surrounding landscape. then she opened the bronze doors and stole quietly inside. always the church was left open for prayer, but today on entering mildred thornton found it empty. a russian church is unlike all others except the greek, for it is filled with brilliant colors. instead of images such as the roman catholics use, the russians have paintings dealing with the life of christ, almost obscuring the ceiling and the walls. there are no pews such as we find in our own churches, for the russian remains standing during his ceremony and kneels upon the stone floor in time of prayer. so one finds only a few chairs scattered about for old persons and ill ones. mildred secured a stool and sat down in the shadow, gazing up toward the high altar. she was an episcopalian, therefore the russian church and its services did not seem so unusual to her as they did to barbara meade. really she had been deeply impressed by the few services she had seen. there was no organ and no music save the intoning of the voices of the priests, and the words of the service she could not understand. nevertheless the russians were a deeply religious people and perhaps their reverence had influenced the american girl. this afternoon, although alone, mildred felt strangely at peace. indeed, her eyes were cast down and her hands clasped in prayer, when the noise of some one else entering the church disturbed her reverie. to the girl's surprise the figure was that of a man whom the next instant she recognized as general alexis. he had come into the church without a member of his staff, so that evidently he too desired to be alone for prayer. what should she do? mildred was too confused to decide immediately. feeling herself an intruder, yet she did not wish to create a stir and draw attention to herself by hastily leaving. general alexis had evidently not seen her, too intent upon his own devotions. for he had at once approached the altar and knelt reverently before it. mildred kept silent, hardly conscious of her own absorption and forgetting her meditations in her interest in the kneeling soldier. in these days of little faith, small wonder that it struck mildred as inspiring to see this man of many burdens and responsibilities at the foot of the altar. from a western window the afternoon sun shone down upon him, revealing the weary lines in the great soldier's face. he did not look stern or forbidding to mildred this afternoon, only deeply careworn and depressed. however much his soldiers and the russian people might trust in his power to bring them safely through an attack at grovno, evidently there were hours when the distinguished general suffered like lesser people. mildred thornton understood enough of human nature to realize what general alexis must at this moment be enduring. the fate of a people, of a nation, almost of half the world, in a measure rested in his hands. how inadequate any mortal must feel in the face of such a task! by and by mildred's eyes dropped their lids. she felt that she was seeing too deeply into the holy of holies of the man before her. this would not be just to any human being, unaware of her presence. if only she could get away without disturbing him! doubtless on discovering her general alexis would be angered, or at any rate annoyed, perhaps he might even consider her behavior as characteristic american intrusion. once mildred started to her feet, but she did not try to move again, for at almost the same instant the russian general rose from his knees. his face had become a little less careworn than at the moment of his entrance; his blue eyes, which were remarkable with his other russian coloring, were less sombre. since he did not appear to observe her, mildred was glad for this last glance at her companion. since their one meeting for some reason he had haunted her thoughts more than she could explain. this was partly due to the fact that he was so much talked of at the fortress and so idolized by his soldiers. he was said to be without fear, or any human weakness, but after today mildred thornton knew better than this. unconsciously the girl must have moved or made a sound of some kind at this instant, for general alexis, who had almost reached the door, turned quickly around. at the same time his right hand grasped his pistol. was there a spy or an assassin lurking in his church to destroy him? there were many men of other lands who would gladly give their lives for his. but general alexis' hand dropped to his side again, as soon as it had touched the metal of his pistol. to his surprise he had discovered a pair of blue-gray eyes staring at him earnestly, with almost wistful sympathy. general alexis came back to where mildred stood. "you were here in church with me and i did not see you," he said as simply and naturally as an ordinary person, "i hope i did not disturb you." "_disturb me!_" mildred stuttered a little in her surprise at his words. "oh, i beg your pardon, it was i who should not have been here when you came. but i did not know, that is i did not dream you ever left the fort, while i like to steal in here during the hours i have for rest. i will not come again." general alexis shook his head. "i should be very sorry. rather than that this should happen i would stay away during those hours. but is there not room enough here and peace enough for us both?" without replying mildred inclined her head and began walking toward the door, general alexis keeping beside her. "if you are returning to the fortress and will permit me, i should like to go back with you?" he asked. and again mildred could only stammer a confused acquiescence. in the little court before the russian church general alexis' guard of soldiers was awaiting him. however, at an inclination of his head they fell in at once, marching at a respectful distance behind their general and his companion. "i remember our having a short conversation a few weeks ago," the russian officer continued gravely, after they had gone on a few yards. mildred had been vainly endeavoring to make up her mind whether she should be the one to speak. if so, what on earth should she say? she was glad to be spared having to make up her mind. "you were very kind," the girl returned. "i did not imagine you would know me again, but perhaps it is because i am an american." just as if he had been a young man and an everyday one, general alexis smiled, and mildred was no longer afraid of him. "oh, i may remember you, miss thornton, for other reasons. but to be truthful it is because you are an american that i am taking this opportunity to talk to you again." this time the russian officer hesitated. "you will not mention what i am going to say to any persons except your two american friends," he added, not as a request, but as a command. "miss thornton, as soon as it is possible for convenient arrangements to be made for you i want you to know that i intend having you sent back to petrograd. you must of course have a safe escort or i should have seen to the matter sooner." ordinarily mildred thornton possessed unusual self-control, but the surprise, indeed, the shock of the speech, took her unawares. she had not dreamed that she and barbara and nona had been such complete failures in their red cross work. why, after their several years of war experience they had felt themselves of perhaps unusual value in the russian nursing. so far as she knew there had been no complaints of their work, only praise. but in any case how could their failures have reached general dmitri alexis' ears? it seemed incredible that he should ever be annoyed with such trifling concerns. "just as you wish," mildred answered quietly, yet with greater personal dignity than any one of the other american red cross girls could have summoned. "we have done our best to help with the nursing. if we have failed it is, of course, wisest that we should return to petrograd. afterwards we can go home to the united states." "failed in your nursing? and it is for that reason you believe i wish to have you sent away from my fortress?" actually general alexis stopped in his walk and faced his companion, since mildred was, of course, obliged to stop also. "that is folly. i know nothing of your nursing. but from your face, from a something, a serenity and strength that your presence suggests, i feel that you must understand and love your profession." general alexis was now studying mildred thornton with surprising intentness, as though he were trying in this moment of their acquaintance to pierce beneath the surface of the girl before him. this was characteristic of the man. no human being was ever too small or too unimportant for his consideration. he was a strange combination: a great soldier and yet one of the gentlest of men. "i want you to go back to petrograd because i fear for your safety and the safety of your friends should you remain much longer at grovno," he continued. "it is of this fact you are not to speak. i have reason to know that at almost any hour in the next few days we may expect the german attack. grovno will resist to the uttermost. but it may be that the old fortifications are not so invincible as we once thought them to be. a new war has brought a new world and the old order changeth." once again mildred saw beneath the outer surface of the man, but almost at once he was again the soldier. "you understand that i do not expect this. if i decide it may be wiser to retreat, it will only be to form a conjunction with another part of grand duke nicholas' army. but in any case i should prefer to have you three american nurses away from all possible danger. the russian nurses will share the fate of their own soldiers. be prepared to leave within a few days. when the necessary arrangements are made you will receive instructions." then before mildred could protest, and she had scarcely the courage for this, they had reached the gate of the fortress. here general alexis bowed and waited for his guard to come up with him. mildred could feel the surprise even of the sentries at the gate and the few soldiers who chanced to be near at their unexpected appearance. truly it was amazing that the great commander should be concerned with the fate of three unimportant american girls, and even more amazing that he should actually show his consideration and friendliness to one of them! chapter viii _another warning_ two hours after sonya valesky had been taken away by the russian police nona davis started back for the russian fortress. only a few moments were required to pack her own belongings, since the little house and everything inside it had been fumigated as soon as sonya reached a state of convalescence. nona's time had been spent in trying to comfort sonya's servants, old katja and nika, and also in trying to acquire some information from them. in neither effort was she successful. either the old man and woman knew nothing of sonya's actions, or else they were too grief-stricken to confide their knowledge. there was also the third possibility that sonya had warned them against betraying her to any human being. whatever the reason, they were dumb, except for their half-broken russian prayers and stories of sonya as a little girl. if she had not long ago been fully aware of the fact, nona was now assured that the two peasants had been former servants of the russian woman. it was sonya who would not recognize the distinctions of maid and mistress, who called herself by no title and would allow her servants to call her by none. therefore it was almost night when nona left the little hut, old nika carrying her bag and plodding behind her. the girl felt that she must return to her two american friends to receive their aid and sympathy. surely something could be done for sonya, it was horrible to think of her being carried off to a russian prison, concerning which one had read such dreadful stories. she was too ill and she seemed so utterly without friends or relatives. yet nona herself was utterly powerless, knowing no one with any influence in russia. nevertheless she felt a strange bond, which had come to her out of the past, between herself and sonya valesky. one person, however, might be willing to give her advice, though she doubted his help. in returning to the fort, nona meant as soon as possible to request an interview with the young russian officer, michael orlaff. she was not frightened during her walk through the dismal russian country. wearing her red cross uniform she felt a sufficient protection, besides old nika's presence. but the real truth is she was too absorbed in considering sonya's history and fate to be aware of anything else. she was therefore more annoyed than frightened when a figure appeared before her at the crossing of the road by the three pines. the voice that straightway called out to them held a quality of command that made nika drop at once on his knees. nona was not in the least frightened, but then she had seen the outline of the young officer's figure and the glistening of his sword hilt. "i am nona davis, an american red cross nurse on my way back to the fortress, lieutenant orlaff," the girl explained. "i am glad to have met you, as perhaps you will tell me what i must do when i reach the gate." the russian officer saluted as though nona had been a superior officer. "i was on my way at the present moment to sonya valesky's home to inquire for her. this is the first hour of freedom i have been able to command all day. but tell me what brings you back to the fortress at this time? has sonya grown worse or is she better?" here was her opportunity. nona felt that fate must have sent it to her by a special dispensation. now there need be no delay in her confidence. lieutenant orlaff came of a noble family, he must have powerful connections, if he could only be persuaded to use them in sonya's behalf. certainly he had appeared to be her friend, although disapproving of her behavior and views of life. as sympathetically and as quickly as possible nona told of the coming of the russian police. then she laid great stress on the fact that sonya was too ill to have been taken away at such a time. yet she had gone without resistance, making no plea for herself and asking for no aid. what must _they_ do? the situation was unendurable. intentionally nona used the pronoun "they," including lieutenant orlaff with herself in their interest in sonya. yet except for his first muttered exclamation the russian officer had made no comment. in the darkness nona gazed at him resentfully. the russians were a cruel people, sometimes all fire and then again all ice. she would like to have told him what an american man would have attempted for a friend, who was a woman and in such a tragic position, no matter what her crime or mistake. but nona was sure by this time that sonya valesky had committed no crime. she had come to know her too well, her exquisite gentleness, so oddly combined with a blind determination that took no thought of self. besides she recalled her friend's final words, "a follower of the prince of peace." surely there were but few such followers in the european world today! awaiting his answer, nona continued to look at her companion. the young russian might have stood for the figure of "mars," the young god of war, as he strode along beside her. he was six feet in height, splendidly made, and tonight in the semi-darkness his face showed hard and unmoved. "i am grieved but not surprised at what you tell me," he returned the next moment. "not a hundred, but a thousand times i have warned sonya that she must give up her mad ideas. there was sufficient danger in them when the world was at peace. now in time of war to preach that men are brothers, that there should be no such thing as patriotism, that all men are kin, no matter what their country, there never was such folly. it is hard to feel pity or patience." "then you will do nothing to help?" nona inquired, trying to hide the anger she felt. "of course i understand that from your point of view and from the view of nearly all the world sonya valesky is hopelessly wrong. but i can't see why she should be punished because she has a higher ideal than other people?" if nona had only thought for a moment she would have realized that the world has always thus rewarded its visionaries. "but sonya is not content to think in this way alone. she has spent her life in trying to persuade other persons to her view, and has many followers. once she was a very rich woman and traveled in many lands preaching her universal brotherhood," the young officer ended his speech with a characteristic shrug of his shoulders, which is the oriental fashion of announcing that fate is stronger than one's will. "to have continued advocating such a doctrine in a time of war was worse than madness. i have done what i could, i have even risked my own honor and safety in remaining sonya's friend. now retribution has come," he concluded, as though the subject was not to be resumed. and nona did not reply at once. so the young russian officer and the american girl walked on toward the fortress through darkness that was each moment growing more dense. there were no lights save the stars, since the fortress was only dimly lighted in the interior; outside lights would too plainly have exposed their position to the enemy. "what then do you think will become of sonya? what punishment will she have to suffer?" nona inquired when she felt that she had gotten her voice under control. "siberia," lieutenant orlaff returned briefly. then feeling that his companion desired him to say more, he went on: "in many cases a man or woman who has done what sonya valesky has would be hung as a traitor. she has been preaching peace, which means she has been urging men not to fight. that is treason to russia. but i believe that sonya will be lightly dealt with because she comes of a family that once served the czar and his father. besides, sonya is a woman and a beautiful one and it would not do to make a martyr of her." "then you think siberia a light punishment?" nona questioned, no longer trying to keep the bitterness out of her tones. "well, surely you accept a friend's misfortune easily! i have not your philosophy. i do not think i can do much, as i have no friends in russia and no money, but as soon as i receive permission i shall go to petrograd to be of whatever service i can." lieutenant orlaff stared at the girl beside him. it was impossible to see anything but the outline of her face, yet he could observe its pallor and the sheen of her hair under the nurse's cap. besides, he felt the contempt she had not allowed herself to express, for the russian is singularly proud and sensitive. "i repeat that i am very sorry," the young officer added. "you are wrong in thinking i take sonya valesky's fate lightly. her family and mine, as i once told you, have been friends for many years. after the death of her parents my father was for a little time her guardian until she came of age. i will do what i can; i will write letters to her relatives and to people who were once her friends. but i warn you to expect nothing. long ago they became weary of her wild theories and have had nothing to do with her for years." "then all the more reason why i should do what i can. even if i accomplish nothing, at least sonya will have the comfort of knowing that a friend is near her during her trial," the girl said aloud, although really not addressing her companion. during the latter part of his speech she had been thinking very rapidly. first of all, she must ask for a leave of absence from her red cross nursing and explain that it was necessary for her to return to petrograd for a time. but where was she to obtain the money for her expenses? she had nothing of her own except the few roubles which she was paid for her work and which she had forfeited when she undertook to care for sonya valesky. in all probability when mildred thornton knew her mission she could borrow the money from her. but then this would mean a delay so long that she might be of no service to sonya. for mildred kept only a small amount of extra money with her and would be compelled to write her father for any large sum. weeks would pass before judge thornton could receive his daughter's request and then there would be more time required for the transmission of the check. however, besides mildred there was eugenia who could be appealed to for aid. there was no doubt of eugenia's assistance, once she learned sonya valesky's story and realized why she had seemed a suspicious character to all of them in the days of their meeting on board the "philadelphia." but eugenia was away off somewhere in france nursing in a red cross hospital near her husband's line of trenches. it would also take time to reach eugenia. nevertheless she was the best person to whom to make a request. "but what connection have you with sonya valesky? why should you not be willing to leave her to her fate?" lieutenant orlaff had to ask the second time before nona heard him. "you have done what you could in nursing her through a dangerous illness; friendship could expect nothing more. besides, you are an american girl and can have only a slight acquaintance with sonya." again nona davis did not reply immediately. how much or how little should she take the russian officer into her confidence? however, it did not seem to her of much importance then. "you are mistaken. i am not simply an american girl," nona explained quietly. "my father was an american, but my mother was a russian. she and sonya valesky knew each other as girls, although my mother was the older. there is a stronger tie between us than you imagine. and i have reason to believe that my mother once thought as sonya does about many things." "your mother, impossible!" michael orlaff exclaimed, with more consternation and regret in his voice than was reasonable. "but you, surely you cherish no such ideas?" the american girl shook her head, although she seemed to be pondering over her companion's question before replying. "no," she returned at last. "i have no such ideas and i believe never will have them. even though my mother was a russian, i am an american in all my feelings and instincts and training. russia fascinates me, but it frightens me at the same time. besides, it is not necessary in our country that we should teach peace and equality, because it is in those two principles that the american people most believe. if sonya is released i mean to try and take her back to the united states with me to remain until the war is over." "but sonya will not be released, i have tried to make you understand," lieutenant orlaff added doggedly. "what is one woman more or less in times like these? go to petrograd if you will, miss davis. i have told you it is not wise for you and your friends to remain at grovno. but when you reach petrograd have nothing to do with sonya valesky. i have known you only a short time, yet i am your friend and i warn you. cannot you see that i care very much what becomes of you? you are a guest in my country; you have come to do us a service. it would be a poor return if trouble overtook you." nona and lieutenant orlaff with old nika hobbling behind them had by this time about reached the entrance to the fortress. nona was truly grateful. she was very tired and depressed from the day's experiences. moreover, she did not understand the manner or the words of the young officer beside her. at one moment he seemed extraordinarily hard and at the next unnecessarily concerned. nothing could happen to her in petrograd of a serious character, but in any case her experiences could not interest lieutenant orlaff. as soon as possible nona said good-by to him. later, in recalling their conversation, she often thought of a phrase he used: "what is one woman more or less in times like these?" chapter ix _the attack_ there was a great deal more for the three american red cross girls to confide to one another than they could find time for, soon after nona davis' return to the fortress. but two evenings later it chanced that the three girls were all on day duty and therefore had the same evening and night free. in the left wing of the fortress, near the hospital quarters, was the single, small bedroom which the three american nurses shared. once before nona had discovered barbara meade rereading one of dick thornton's letters and giving way to the blues in their small, cold chamber. this evening she made the discovery a second time. it chanced that barbara had gotten away from her nursing first and hurried off to the only privacy that was possible under the circumstances. because she was looking forward to a long and serious conversation with her two friends she made ready to meet the situation as comfortably as possible. this means that barbara slipped out of her nursing uniform and into the pretty kimono that mildred had presented her with long ago in paris. then, while she waited for the others, she read dick's and eugenia's latest letters once again. at last dick had arrived in new york city and was writing from the lovely home barbara remembered so well. he had only been there a little while when this letter had been written, but already dick had confided the news of his engagement to his mother and father. barbara could read between the lines in a characteristic feminine fashion. dick declared that his father was delighted to hear of his happiness and that he had not forgotten that they probably owed their son's life to the girl to whom he was now engaged. but judge thornton agreed with his son--a man should be able to support his wife before he married. therefore he meant to do all that he could to get dick started in the right way, so that he might go ahead as quickly as possible. dick did not seem to feel that it would take very long to accomplish this delectable result, but to barbara, away off in russia, a land she both disliked and feared, the situation looked pretty indefinite. moreover, dick had said nothing about the way in which his mother had received the news of a prospective daughter-in-law. this was not an oversight on dick's part; barbara understood him too well to be deceived into any such impression. he and his mother were too intimate and devoted for him not to care intensely about her attitude toward the girl he wished to marry. never could he have forgotten to mention his mother's position! no, it was merely what she had always expected. mrs. thornton thoroughly disapproved of her son's engagement and dick would not wound the girl he loved by writing her this fact. later there was a chance that his mother might be persuaded to change her mind. but in any case it would be easier to explain by word of mouth than coldly to set down the present situation. moreover, if barbara had required further proof, she would have had it in the fact that mrs. thornton had not written her a single line to say either that she was glad or sorry that the daughter of her husband's old friend had become engaged to her only son. if she had spoken of the matter to mildred, mildred had never referred to it, proving again that any comment from mrs. thornton must have been unfavorable. while she made these reflections following the rereading of her fiancé's letter, barbara was lying on her cot-bed with an army blanket drawn close up under her chin. now she buried her curly head deeper in her pillow and turned from dick's to eugenia's letter. it was difficult to think of eugenia peabody as madame castaigne, indeed as the countess castaigne, only neither she nor her husband would ever be induced to use their titles. the old countess might always remain in safe possession of hers. barbara wondered if eugenia was happier than she was. then she felt ashamed of herself. eugenia's husband was every instant in danger of losing his life, while dick had only returned to the united states, where he was now safe in his own home. yet eugenia's letter made no complaints. she mentioned having seen captain castaigne once in the past month, when he had received a leave of absence of twenty-four hours and had hurried to her. no, eugenia's letter was chiefly devoted, as all her previous letters had been, to her interest and concern in the three american red cross girls. she wished them to return immediately to france and to the old chateau, where the countess castaigne would be only too happy to shelter them. later, if they wished, they could find other red cross work to do in france. but russia was not a country where the girls should have gone at this time, and certainly not without her to look after them. moreover, the news from the russian lines grew more and more alarming. everywhere the germans seemed to be conquering. it was disheartening after the russian triumphs at the beginning of the war. the letter closed with a final plea: would barbara do her best to persuade nona and mildred that they should as soon as possible come back to france. there would be no cowardice or desertion of duty in leaving russia at present, only discretion and good sense. and upon this point of view barbara was reflecting when nona found her. personally barbara agreed with eugenia and wished that nona and mildred would join her in withdrawing from russia whenever they could best be spared. but she could not decide whether she ought to thrust her point of view upon her friends since she was uncertain whether her judgment or her desire most swayed her. france would be so much nearer new york and therefore dick's letters could be so much more frequent. then there was the countess castaigne, to whom she could pour out all her heartburnings. moreover, there was the chance of every now and then seeing her beloved eugenia. but barbara also remembered that she had always been the least brave and determined of the four american nurses ever since their arrival in europe. should she reveal herself in the selfsame light again? at this instant nona snuggled under the blanket beside the younger girl. the russian winter was fast approaching and frequently it was bitterly cold. besides, there were no chairs in the red cross girls' bedroom, only the three beds and some stools, so it was simpler to lie down than be seated. "i have a long story to tell you, bab, and i want your advice, only i think we had best wait for mildred, so you may not have to hear everything twice," nona began. "you mean about sonya valesky?" barbara queried. of course nona had told her two friends of sonya's arrest, but had not been able to go into the details of the story, nor had she mentioned her own intentions. very possibly both the girls would disapprove, as lieutenant orlaff had done, of her becoming more closely involved with sonya valesky's history. fortunately mildred appeared at the door without further delay. but when she entered the room, both of her companions could see that she also had something of importance upon her mind which she wished to discuss at once. instead of lying down, mildred immediately seated herself upon the edge of her cot, facing her friends. then she drew her own blanket up around her shoulders. "girls," she began, "i don't usually do the talking, but i want both of you to listen to me for a few moments tonight. i have been trying to speak of this for several days, and if i don't tell you now the order may come when you are wholly unprepared. we are to be sent back to petrograd as soon as a safe escort can be found for us." "sent back to petrograd! thank fate for even so much!" barbara whispered under the cover. "petrograd might be the beginning of a return journey to france." then she drew her chin up, endeavoring to appear deeply wounded. "do you mean, mildred, that our services as red cross nurses are not considered valuable?" she demanded. "why, only today one of the russian surgeons declared that it was difficult to decide which one of us did the best work. of course, i think mildred at present deserves the prize, nona has been off duty so long in taking care of sonya valesky." mildred thornton glanced from one girl's face to the other. in spite of barbara's effort to conceal her pleasure, it was evident that she was secretly rejoicing. but mildred understood barbara's position; it was natural that she should feel as she did under the circumstances. then barbara had never put forth any claims to being a martyr. what really surprised mildred thornton was nona davis' expression of relief, almost of pleasure, at her news. why, nona had been more enthusiastic than any one of them over the red cross nursing in russia! she it was who had originally planned their coming into russia and had been most deeply interested since their arrival. "but why are we to be sent back to petrograd?" nona also demanded, frowning a little in her effort to grasp the situation. "what reason was given; have we failed in any duty or service since our arrival at grovno?" nona went on, sitting up, while two spots of color appeared in her cheeks. "please, mildred, don't be mysterious. tell us where you received your information and why we are to be sent away so ignominiously?" mildred thornton shook her head in quiet reproach. she was not so impatient nor so unreasonable as the other two girls. "i am waiting to tell you," she returned. "the other afternoon i was sitting alone in the little russian church when general dmitri alexis came in. on leaving he chanced to discover me and asked me to walk with him for a few moments. you know i told you i had met him the day he came into my hospital ward to decorate the dying soldier?" mildred added. this time her companions only nodded, not wishing to interrupt. "well, it was general alexis himself who said that he wished us to go back to petrograd. it was not that he felt the fortress at grovno would not be able to hold out against the german attacks, but that a soldier should be prepared for any emergency. in case grovno should fall, or general alexis decide it wiser to retreat and join another portion of grand duke nicholas' army, he does not wish us at grovno. he says that the russian red cross nurses have the right to remain with their own soldiers, but that we are americans and with us the circumstances are different. he does not intend that harm shall befall us. so i am afraid we have no choice in the matter. as soon as the order comes from general alexis we must be ready to leave at once. one can scarcely dare disobey the commander in chief," mildred concluded, with regret in her tones. "certainly not," barbara added with emphasis. then for another moment nona davis continued gazing thoughtfully at mildred. "i suppose i ought to tell you, mildred, you and barbara both, that i am not sorry we are to go to petrograd; indeed, i am truly glad. because i had intended to try to get permission to return there alone. you know i told you of sonya's arrest, but i did not tell you that i intend to do all that i possibly can to befriend her. she seems to have no one who cares what becomes of her so far as i can find out, except her two old servants, katja and nika. i may not be able to do much, but i have written eugenia, asking her to lend me some money and to forward it to the american ambassador at petrograd as soon as possible. i would like to leave almost at once. you see, i don't know what has become of sonya, nor when her trial may take place." "and for my part i hope you may never know," barbara protested, sitting up with her cheeks suddenly crimson and her hair much tousled. "see here, girls, i know neither of you think much of my advice, and very probably you don't consider me especially brave. i'm not disputing the last point. but i am more sensible than either of you and i can see both sides of a situation better. mildred is an idealist, and nona, you are a dreamer. you think you are not, but i expect you have more of your mother's blood in you than you realize. i am desperately sorry for sonya valesky. i think she is an exquisite and much-wronged woman with the courage and devotion necessary to a martyr. but i don't see that you are particularly fitted to follow her example, nona. that is all that would happen if you attempt to mix yourself up with sonya valesky's political fortunes in petrograd. you have no important friends and could do absolutely nothing for her, but you might manage to get yourself and us, because we care for you, into a great deal of hot water." mildred began to undress. "i think bab is right, nona, though i understand just how you feel. it does seem too cruel to desert a friend in a time of such extremity. when we get to petrograd perhaps we can talk sonya valesky's case over with our ambassador and he may help us with his advice. let's get to sleep now; we can judge more wisely in the morning." it was too cold for a leisurely disrobing, so in a very short time the three girls were ready for the night. soon after they were asleep. for many hours, lasting all through the darkness, the fortress at grovno appeared wrapped in a profound silence. this in spite of the presence of many thousands of men without and within its gates. now and then there may have been the faint noise of a sentry changing his watch, or a scout arriving with a report for headquarters. it was just at dawn when the german attack began. but the russian general had been warned and was awaiting it. never in all the grim history of war was there ever a more sudden or more terrific cannonading. the three american girls were at first stunned by the unexpected noises of the explosions. shell after shell shrieked over the walls of the fortress, cannon after cannon repeated an unceasing bombardment. neither were the russian guns slow in replying. except for the location of the sounds it was impossible to tell which were the russian cannon and which those of the enemy. for some time no one of the three american girls attempted to speak. it would have been impossible to have heard one another. but by and by barbara crawled out of her cot and put her arm about mildred thornton. "i am frightened, mildred. i wish your general's order had come sooner and we were safely away from grovno. i think perhaps because of dick i don't want anything dreadful to happen. i want to be happy." there was a sob in barbara's voice which mildred heard, if not with her ears, at least with her heart. "it is going to be all right, little sister," she returned. "i can't explain exactly why, but i have perfect faith in general alexis." chapter x _mildred's opportunity_ for five days and nights the firing continued almost without cessation. in a measure the occupants of the russian fortress grew accustomed to the noises, unless one explosion seemed a little more terrific than the others. actually the red cross nurses went about their work inside the hospital wing of the fort as though the germans were not attacking. there was one fact, however, that could not be overlooked: more and more wounded were constantly being brought in, until not only the cots but most of the floor space of the wards were covered with stricken soldiers. there was no definite news. no one could say whether the germans had been seriously depleted by the russian gun fire, or whether the grovno fort would be able to continue its resistance. a few of the outer defenses had already fallen. the russian soldiers in the trenches behind the first line of barricades had sought safety inside the fortress. but these signs meant nothing of moment, and no one dared ask questions of the russian officers, who alone might know the purpose of their commander. then on the morning of the seventh day, at dawn, mildred thornton, who chanced to be gazing out of a small window which overlooked the courtyard of the fort, made a discovery. she had not been asleep all night, as there was so much work to be done, but on the way to her room had stopped for a single breath of fresh air, after the fever and confusion of the hospital. what she saw were enormous cannon being lifted on low motor trucks and these trucks being driven as swiftly as possible outside the grovno gate and along the russian highway. there were a few soldiers accompanying them. almost with the flash of an intuition the idea came to mildred: general alexis was contemplating a retreat. he must have decided that, alone and with only a limited number of regiments at his command, he would be unable to hold out against the enemy for an unlimited time. therefore it might be wiser to draw them further into russia and away from their own supplies. general alexis could join grand duke nicholas beyond the styr river and there be better prepared to meet the invaders. mildred knew that the country on the other side of the river covered miles of swamps. if the bridges over the river were destroyed, the germans would find great difficulty in pursuit. therefore the cannon and other heavy guns, with whatever munitions could be spared, were first to be taken to places of safety. later on general alexis would probably give orders for a more general retreat. but when grovno fell the germans would find none of the spoils of war left behind for the victors. all this mildred thought out slowly and carefully as she stood for a few moments beside the tiny window. then she went into her room, changed her uniform for a fresher one and returned to her work. not a word of her idea did she breathe to any one. she had no foundation for her impression, and at first it was an impression, nothing more. yet barbara or nona might have been frightened by the suggestion. however, as the dawn passed and the hours of the day followed, other persons beside mildred thornton began dimly to appreciate the possible conditions. more and more of the munitions of war were hauled away, and surely this did not look as if the fight were to be persisted in at grovno. finally, just before twilight the order came that the wounded, with their nurses and surgeons, were to be moved at nightfall. whatever preparations were necessary must be made at once. silently small groups of soldiers were already being marched away. oh, of course the old guns of the famous fortress continued to belch forth destruction, and there was no lessening of the front ranks of soldiers, who were directly attacking the enemy. general alexis was merely drawing off the men whom he did not actually need for defense. grovno could be protected by a comparatively small number of soldiers without the enemy appreciating any depreciation in their numbers. for all the firing was done behind a barricade of walls. so far the germans were about a mile away. there would be no hand-to-hand combats until the fortress was finally demolished. even under such dangerous conditions the american red cross girls were relieved to hear that they were to be sent from grovno. they were also told that they were not to follow the army. as soon as they reached a railroad, the wounded and their nurses were to be removed to petrograd. there they would find hospitals ready for their accommodation. so it was to be petrograd after all! the three girls were not seriously frightened; indeed, they were less so than at the time of the french retreat. it was so evident that general alexis was providing for the safety of the wounded before the danger time. they would find all the roads open to them now, while the germans were being held on the farther side of the ancient stone walls. just after dusk the hospital staff and their patients were ready for departure. parties of ten, consisting of seven wounded soldiers, two nurses and a physician, gathered quietly in the stone courtyard enclosed by the wings of the fortress. they were then placed in low carts, drawn by gaunt horses and driven by a russian moujik, wearing a long blouse, high boots and a cap with the peculiar russian peak. there were no such facilities for transportation in russia as the american red cross girls had found in france. the motor cars and ambulances owned by the russian army were few in number and inadequate to their needs. these could only be employed in cases where swiftness was a pressing necessity. the three american girls were standing together just outside a stone doorway leading into the yard and awaiting orders. as a matter of course they wore their red cross uniforms: the long circular cape and the small close-fitting bonnet. but barbara had also put on nearly everything else she possessed. they would be traveling all night under extremely uncomfortable conditions and through a bitterly cold country. in fact, barbara looked rather like a little "mother bunch" with her squirrel fur coat on top of her sweater and her cape over them both, and carrying her army blanket. mildred was also prepared for the cold with a heavy coat under her uniform cape. unfortunately, nona owned nothing to make her more comfortable, except that mildred had insisted upon lending her her sweater. but both girls had their blankets over their arms and small bags in their hands. there would be no room for other luggage. "we are going to have a wonderful night, i think," barbara murmured. "of course it will be hard and we may have to suffer discomfort and see others suffering far worse things. but a retreat through this strange country, with its odd inhabitants, as unlike as if they belonged in different planets, will be an experience none of us will ever wish to forget." it was curious that barbara should almost whisper her little speech, as if her voice could be heard above the uproar of the cannonading. yet in the pauses between the firing lasting a few moments the silence seemed almost unearthly. at present there was just such a silence, so that the american girls could even hear the creaking of the old wagon wheels as the ambulance carts rolled out of the fortress yard. now and then there was a faint groan from a wounded man that could not be repressed. the wagons had no springs, but were made as comfortable as possible by layers of hay covering the wagon floors. almost the moment that barbara's speech was finished, some one suddenly stepped out of the door, near which the three girls were standing. looking up they discovered a colonel in the russian army, on the personal staff of general alexis. no one of the three girls knew the officer's name; his rank they recognized from the uniform he wore. moreover, they had observed him always accompanying the russian commander as one of his chief aides. his appearance in the courtyard at this moment was surprising, but in all probability he wished to issue a direct order concerning the plan of retreat. yet the officer did not at once move forward to where groups of soldiers were also making preparations to be on the march. instead he stood for a few moments just outside the door, gazing searchingly about him. no one of the red cross girls spoke. they were too awed by the gravity of the situation to make trivial remarks. moreover, the big russian officer was an impressive figure. it was more interesting to watch him until they were summoned to take their places in the wagons that were now leaving the fortress at intervals of about ten minutes apart. by chance mildred thornton made a movement and immediately the russian colonel directed his glance toward her. he stared at her for a moment in silence and then, stepping forward, touched her upon the arm. "i should like to speak to you a moment alone, nurse," he announced in low tones, although barbara and nona both heard this part of his speech. instantly mildred complied, and the girl and man moved a few feet away, where they could talk without being overheard. under the circumstances neither barbara nor nona had the temerity to follow them. but this did not mean that they were not both extraordinarily curious. at least they strained their ears as much as possible in order to try and catch a stray word spoken either by mildred or her companion. but they heard nothing except the low murmur of the two voices, the officer asking questions and mildred making replies. "what on earth do you suppose he can be saying to mill?" barbara finally whispered. nona only shook her head. any guessing would be a pure waste of energy, since mildred would return in a few moments to explain. she did come back almost immediately, but with her first words her friends realized that something unusual had occurred. ordinarily mildred was calm and self possessed. now her voice shook and indeed she seemed to be shivering either from cold or excitement. "i can't go with you to petrograd, girls," she said quietly enough, however. "listen, please, so i can make matters plain to you, for you may be ordered to leave at any moment. barbara, i want you to write my father and mother and try and make them see i had no choice in this decision. but you must not speak of the circumstances to any one else. it would be dangerous for me and for us all if you betray this confidence. the officer who talked with me just then is colonel feodorovitch. he is very near general alexis and tells me that general alexis has been wounded. the wound is not considered serious and he refuses to give up his command or to leave the fort until the final moment for retreat. neither must his soldiers learn of what has taken place. his own surgeon is with him now and will remain with him. but there is a chance that they will also require a nurse. colonel feodorovitch came to find one before we all got away. by accident he saw me first and requested me to remain behind. i could not refuse." "mildred!" nona and barbara exclaimed in unison, with no attempt to conceal their dismay, almost their horror. "but you can't accept, mildred," barbara expostulated. "if you do i shall not leave you. why, what would your mother and father and dick think of my deserting you at such a time? besides, don't you remember that general alexis himself wanted us safe in petrograd before the retreat. he would be bitterly opposed to your being chosen to remain behind. didn't you speak of this to colonel feodorovitch?" "i couldn't, barbara," mildred insisted. "it would have been such a long story and colonel feodorovitch knows about as much english as i do russian. it would only have looked as though i were shirking a most important duty. general alexis will not recall ever having thought or spoken to me, at a time when the russian army, perhaps the whole russian nation, is dependent on his failure or success. if i can do even the least thing to help him at such a crisis, why, how could i refuse? please try and see this as i do, barbara, you and nona. there may be nothing for me to do. general alexis' wound is not serious or he could not retain his command. i must leave you now; i am wanted at once. i'll join you in petrograd as soon as it is humanly possible." but barbara had clutched mildred's coat. "you shall not stay alone. i am almost your sister and i won't allow it." quietly mildred unclasped the younger girl's hand. "for my own sake i would give a great deal to have you stay, bab, but we have no choice. remember, we are under discipline like soldiers. we must do as we are commanded." with this mildred returned inside the fortress. at the same instant nona davis and barbara meade heard their names being called. at once they moved forward and were assisted inside the wagon, which soon after passed out of the gate and moved creakingly along the main road in the direction of the styr river. they were to cross one of its bridges, as the main army was now doing. the last of the regiments at grovno would see that the bridges were destroyed before the german soldiers could come up to them. chapter xi _a russian retreat_ for many hours the ambulance wagon in which nona and barbara were riding jogged on, forming one of a procession of similar wagons. the girls grew cold and cramped. now and then they tried to move in order to make their patients more comfortable or at least to give water to the wounded men. but the wagons were so crowded that the slightest stirring was well nigh impossible. nevertheless, as barbara meade had predicted, the long night was one neither she nor nona would ever be willing to forget. at first they rode along, passing the wooden huts of the peasants that once had lined both sides of the main road leading to the middle bridge across the river styr. but many of these shacks had suffered from the stray shells of the germans, which, having passed beyond the fortress, had brought desolation to the country side. these little wooden houses in many places were mere heaps of burnt-out ashes. others were half burned, or else collapsed, as if they had been houses built by children, who had afterwards kicked them down. everywhere, from the little homes that were unhurt, as well as from the ruined ones, the peasants were fleeing. with the passing of the first russian regiment _away_ from grovno they had guessed what must inevitably follow. there were bent-over old women and men carrying packs on their backs like beasts of burden, and in truth the russian peasant has been nothing more for many centuries. the children, who ran along beside them, were incredibly thin and dirty and hungry. one member of each little group would carry a lighted pine torch, pointing the way with fitful shadows. but wherever it was possible they followed in the wake of the wagons. at first the night was dark and the american girls could hear their driver muttering strange russian imprecations as his horses stumbled and felt their way along. finally barbara presented him with the electric lamp, which had been dick thornton's farewell present to her on the day of her sailing from new york city. she had used it many times since then, but never for a queerer purpose. however, before they reached the river the moon had risen and both nona and barbara were grateful for the added light. yet the scene they next witnessed was lighted by many camp fires. the russian infantry, who had been first to begin the retreat from grovno, had camped on this side the river for a few hours rest. a confused murmur of sounds arose. in little knots before the fires men squatted on their knees in oriental fashion, waiting for the copper pots to boil. for at all hours of the day and night the russian drinks tea, now more than ever, since by command of the czar the soldier is forbidden to touch alcohol. the girls could observe that the men had curiously unlike faces. it was difficult to understand how they could all be russians. never before had they seen so many of the soldiers at one time. some of them had flat faces and high cheek bones, with eyes like the chinese. it was very strange! yet nona whispered that they must remember some of these russian soldiers had come from asia, from beyond the caspian sea. perhaps their ancestors had been members of the great mongolian horde that had once invaded europe under genghis khan. in their interest nona and barbara began discussing the possible history of these soldiers aloud. by and by, one of the wounded men, who chanced to be a russian university graduate, smiled to himself over the interest and excitement of the two american nurses. he had been suffering intensely from the jolting and was glad for anything that would distract his mind from his suffering. "the soldiers you are discussing are called 'turcomen,'" he remarked aloud. nona and barbara were startled by the voice out of the darkness, but they murmured confused thanks. "perhaps we had best not discuss our surroundings so openly," nona suggested, and barbara agreed with a silent motion of her head. by this time they had reached the central bridge. it was built of steel and stretched like a long line of silver across the dark river. over the bridge, like enormous over-burdened ants, the american girls could see other ambulance wagons moving slowly on. for the horses had become weary of their heavy loads and yet were to have no rest of any length until daylight. on the farther side of the river there were other small encampments. but by and by barbara meade fell asleep with her head pressed against nona's shoulder. occasionally nona drowsed, but not often. she was torn between two worries. what would become of mildred thornton, left behind with strangers in a besieged fortress that might fall at any hour? surely her situation was more fraught with danger than any in which the red cross girls had found themselves since their arrival in europe. nona wished that she had taken sides with barbara more decisively and refused to leave grovno unless mildred accompanied them. but mildred had disappeared so quickly. then the order had come for their departure almost at the same instant. there had been so little time to protest or even to think what was best. certainly mildred herself should have refused to accept such a dangerous responsibility. but at the same moment that nona condemned her friend, she realized that she would have done exactly the same thing in her place. in coming to assist with the red cross nursing they had promised to put the thought of duty first. mildred could not shirk the most important task that had yet been asked of her. perhaps no harm would befall her. certainly nona appreciated that everything possible would be done to insure mildred's safety. her life and honor would be the first charge of the soldiers surrounding her. moreover, general alexis would certainly leave the fortress before there was a chance of his being taken prisoner. he was too valuable a commander to have his services lost and the germans would regard him as too important a capture. so nona's attention wandered from mildred to her other friend, sonya valesky. what had become of sonya and how was she ever to find her in the great and unknown city of petrograd? if she only had a friend to consult, but she had even been compelled to leave grovno without seeing lieutenant orlaff again. he had promised to write a few letters in sonya's behalf, although assured that they would do no good. yet in some way nona was determined to discover the russian woman. perhaps the czar himself might be brought to pardon sonya if he heard that she would leave for the united states and never return to russia again. then nona smiled and sighed at the same time over her own simplicity. the czar was at the head of his troops, with the fate of his crown and his country at stake. "what did one woman more or less count in times like these?" before daylight nona must have also slept, because she was finally awakened by the stopping of their ambulance wagon. when she opened her eyes she was surprised to see a rose flush in the sky and to hear the slow puffing of an engine. the wagons had arrived at a small railroad station, connecting with the main road leading into petrograd. word of the approach of the ambulances must have been sent ahead, for a train of more than a dozen coaches was even now in waiting. as quickly as possible nona and barbara crawled out of their wagon, stamping their feet on the frozen ground and waving their arms in order to start their circulation. then they began to assist in transferring the wounded soldiers from the wagons to the cars. the men were wonderfully patient and plucky, for they must have suffered tortures. they had first to be lifted on to an ambulance cot and then transferred to another cot inside the train. a few of the soldiers fainted and for them nona and barbara were relieved. at least they were spared the added pain. yet by and by, when the long line of cars started for petrograd, the occupants of the coaches were amazingly cheerful. tea and bread had been served all of the travelers and cigarettes given to the men. some of the soldiers sang, others told jokes, those who were most dangerously ill only lay still and smiled. they were on their way to petrograd! this meant home and friends to some of them. to others it meant only the name of their greatest city and the palace of their czar. but to all of them petrograd promised comfort and quiet, away from the horrible, deafening noises of exploding bullets and shells. naturally nona and barbara were affected by the greater cheerfulness about them. "if only mildred were with us, how relieved i would be. really, i don't know how we are to bear the suspense of not knowing what has become of her," barbara said not once, but a dozen times in the course of the day. but night brought them into the famous russian capital. chapter xii _petrograd_ on their arrival barbara and nona went with the wounded soldiers to a red cross hospital in petrograd. there, to her consternation, a few days later nona davis became ill. the illness was only an attack of malarial fever, which nona had been subject to ever since her childhood; nevertheless, the disease had never chosen a more unpropitious time for its reappearance. for a few days she seemed dangerously ill, then her convalescence left her weak and exhausted. she was totally unfit for work and only a burden instead of an aid to the hospital staff. poor barbara had a busy, unhappy time of it. she did her best to look after nona in spare moments from her regular nursing, and she also tried not to lose courage when no word came from mildred. neither from newspapers nor inquiries in all possible directions could she even learn whether grovno had fallen. she was unable to read the newspapers for herself and so was compelled to wait until one of the other nurses could find time to laboriously translate the information into english. evidently at the present time the russian papers did not desire the russian people to learn the fate of the fortress and its commander. for all news on the subject was carefully withheld. under the strain barbara might have broken down herself except for a piece of good fortune that at length came to nona and to her. an american woman, married to a russian, the countess sergius, learning of the presence of the two american red cross nurses in the russian hospital, called at once to see if she could do anything for their comfort. discovering nona ill and barbara on the verge of a breakdown, the american woman insisted that the girls be her guests. they were not able to be of special assistance at the hospital under the present circumstances, while a week or so of rest and change might do wonders for them both. in answer to nona's protest that she was not well enough to be an agreeable visitor and could not bear the ordeal of meeting strangers, the older woman announced that the girls could live as quietly as they liked. she would let them have a private apartment in her house and they need see no one except the servants who would look after them. as the american countess was undoubtedly extremely wealthy and most anxious to be of service, barbara and nona gratefully accepted her invitation. so about ten days after their arrival in petrograd they were living in one of the handsomest houses along the famous nevski prospect. this is the fifth avenue of petrograd, a wide avenue three miles in length. nothing is small in russia or in the russian people. the girls were delightfully comfortable. one-half the third floor of the great house had been given up to them, consisting of two bedrooms, a bath, and a sitting room where their meals were served. indeed, the girls soon discovered that although the countess meant to be hospitable and kind, she was sincerely glad that they wished to be left alone. she was an extremely busy woman, one of the important hostesses of petrograd in times of peace. but now, like most society women in the allied countries, she was devoting all her energies to relief work. there were charity bazaars and concerts and russian ballet performances, for the benefit of the soldiers, that must be managed day and night. after three days of luxury and idleness nona davis felt strong again. perhaps more than the other red cross girls she deserved credit for her devotion to her nursing. for nona had the southern temperament which loves beauty and ease, and there were times in her life when she had deliberately to shut her eyes to these enticements. but now, with the thought of sonya valesky ever on her mind, she could not allow herself to relax an hour longer than necessary. contrary to barbara meade's judgment, nona decided to ask the advice of their hostess as to how she should begin the search for her russian friend. instantly the american woman became less cordial. but when nona had told as much of the other woman's story as she dared, the countess frankly discussed the situation with her. if nona would be guided by an older woman she would give up the quest for sonya valesky. certainly sonya's fate was an unhappy one, but she was wholly responsible for it herself. if she had been content to take life as she found it she would now have been occupying a brilliant position. the countess evidently had no use for reformers or persons who break away from recognized conditions. she confessed to nona that her own position in russian society had been difficult to attain. not for worlds would she be suspected of having anything to do with a socialist, or an anarchist, or whatever dreadful character nona's friend might be! the countess was perfectly polite, but nona thoroughly understood that if she insisted upon discovering the unfortunate sonya, her presence as a guest in the countess' home would no longer be desired. since there was nothing else to do, nona decided that she must wait until help came from some unexpected direction. she had no idea of giving up the search for sonya. but in the meantime she could enjoy a brief rest and see petrograd. in the winter time petrograd is the most beautifully quiet city in the world. and now in war times it was scarcely less so, for the ground was covered with many inches of snow. there was a muffled sound even to the tread of the soldiers' feet, marching through the frozen streets. neither was there a single wagon or carriage to be heard, since everybody went about in sleighs and everything was hauled in the same way. but now, because all the best horses were at the front, one often saw great oxen drawing sledges through the once gay and fashionable city. the countess sergius had retained only a single pair of horses for her own use and that of her big household, nevertheless, she now and then loaned her sleigh for an afternoon to her two american girl guests. sight-seeing was the only amusement which kept nona and barbara from a morbid dwelling on their worries. barbara had written to judge and mrs. thornton in the way that mildred had directed. but she could not feel that either of mildred's parents would feel any the less wretched and uneasy because their daughter believed that she was only "doing her duty." since the original letter barbara had never been able to write them again. what could she say, except that no word of any kind had since been received from mildred? there would be small consolation in this news, and of course barbara wrote dick every few days. one afternoon barbara and nona left the countess' house at about three o'clock and drove down the entire length of the nevski prospect toward the winter palace of the czar. there were scudding gray clouds overhead and a light snow falling. no one could have failed to be interested. the russian streets are ordinarily paved with sharp-edged stones, but the ice made them smooth as glass. over the windows of the shops the girls could see painted pictures of what the shopkeepers had to sell inside. this is common in russia, since so many of her poorer people are unable to read. most of the buildings in petrograd are of stucco, and indeed, except for her churches and a few other buildings, the russian capital resembles a poor imitation of paris. peter the great, who constructed the city upon the swamp lands surrounding the river neva, was determined to force russia into the western world instead of the east. for this reason he brought all his artists from france and italy, so that he might model his new city upon their older ones. the winter palace itself the girls discovered to be a renaissance building, with one side facing the river and the other a broad square. their sleigh stopped by the tall monolith column commemorating alexander the first, which stands almost directly in front of the palace. leading from the palace to the hermitage, once the palace of the great catherine, is a covered archway. the hermitage is one of the greatest art museums in the world and contains one of the finest collections of paintings in europe. although the two red cross girls had now been in petrograd several weeks, neither of them had yet been inside the famous gallery. "suppose we go in now and see the pictures," barbara proposed. "we might as well take advantage of our opportunities, even if we are miserable," she added with the characteristic wrinkling of her small nose. "besides, i'm frozen, and you must be more so, nona. how i have adored my squirrel coat and cap ever since we came to this arctic zone! thank fortune, our countess has loaned you some furs, nona! do you know, i really am not so surprised that your mother was a russian noble woman. you look like my idea of a russian princess, with your pale gold hair showing against that brown fur. who knows, maybe you'll turn into a russian princess some day! but shall i tell our driver to stop?" nona davis shook her head, smiling and yet rather pathetic, in spite of her lovely appearance in borrowed finery. "i don't want to be a russian princess, bab, or a russian anything, i am afraid, in spite of my heritage. i think it a good deal nicer to be engaged to an american like dick thornton. if you don't mind, let's don't try to see the pictures today. i am tired and we ought to be fresh for such an experience. if you are cold, suppose we go back into the center of the town and walk about for a while. then we can send the sleigh home to the countess. i don't feel that we should keep it for our use the entire afternoon, and if we stop to look at the pictures it would take the rest of the day. there are some queer side streets that join the nevski prospect i should like to see." the countess sergius lived about two miles away from the winter palace. when the girls were within a quarter of a mile of the house where they were guests, they finally got out of the sleigh. their driver was an old man with a long beard and not the character of servant the american countess would have employed under ordinary conditions. but her former young men servants were in the army, and like other wealthy families in russia at this time, she was glad to employ any one possible. however, nona undertook to make the man understand that they would not need his services again that afternoon. she had more of a gift for languages than the western girl and her knowledge of french was always useful. so after a little hesitation, the big sleigh at last drove away. and actually for the first time since their arrival in petrograd nona and barbara found themselves alone in the russian streets. there could be no danger of getting lost, for they had only to come to this central thoroughfare and the countess' house lay straight ahead. so the two girls turned into the side street that lay nearest them. after a five minutes walk they found themselves in another world. on the nevski prospect they were in europe; here they were in asia. it was curious, but even the smells were different. these were asiatic odors, if the girls had only known, queer smells of musk and attar of roses and other less pleasant things. the russian women and children were crowding the narrow streets, while inside the little shops the wares were displayed on big tables. in the summer time these goods were sold on open stalls in the streets. "let us go into one of the shops and buy a few trinkets," barbara suggested. "i would like to own one of those embroidered russian aprons." then she stopped, her attention caught, as nona's had been, by a sudden rustling in the air above them. a moment later a flock of gray and white pigeons was crowding about their feet. these also were the pigeons that haunt the thoroughfares of the east. personally nona davis would have preferred remaining outside in the fresh air. she was cold, but she objected to the squalid atmosphere of the interior of so many russian houses. however, she could not refuse to agree to every request barbara made of her all that afternoon. a moment later and she was almost as interested as the younger girl in making purchases. there were odd pieces of beautiful, gayly colored embroideries that, according to american ideas, appeared incredibly cheap. then there were bits of russian brass, that seemed to interest barbara particularly, as it is probable that she had a sudden rush of the housekeeper's ardor. here were interesting things that might be purchased for her own and dick's apartment in new york almost for nothing! whatever the cause, nona, after fifteen or twenty minutes, found her own pleasure cooling. moreover, she had very little money to spend on frivolities, and so found a stool in a corner and sat down to wait for barbara and to watch the crowd. there were numbers of people in the shop, although few of them seemed to be making purchases. now and then a big soldier, crowned by his peaked fur cap, would stalk proudly in to purchase a trinket, possibly for the girl of his heart. the russians are ardent lovers, and as the soldier was only at home on a short leave, he had to make the best of his opportunity. most of the women who were not wearing furs had heavy shawls drawn over their heads and shoulders. nona could not see their faces very well, and only received flitting impressions of dark eyes and large, heavy features, with almost always the curiously pale and yet sallow skin peculiar to the russian peasant. it is only among the better classes that one finds other types. suddenly nona gave a cry of alarm, which she quickly hushed. to her surprise some one had quietly come up back of her and laid a hand on her shoulder. it was one of these same peasant women, wearing a heavy, dark shawl. she was trying to say something which nona could not at once understand. yet it was plain enough that the woman was imploring her to make no disturbance that would attract attention. the next moment nona had recognized the woman. it was old katja, sonya valesky's servant, whom she had left with nika in her little hut. what had brought the old woman to petrograd? in reality nona knew without asking the question. it was katja's devotion to sonya. the old woman was speaking a queer jumble of languages, russian and the few words of english she had learned while the american girl was living in the same house. what nona finally learned was, that katja was imploring her to meet her somewhere the next day, where they could talk without being observed. nona knew of no place except the one that was always open to rich and poor alike in russia. and she had to think quickly. yet the churches had always been their refuge ever since the arrival of the four red cross girls in europe. at the same moment nona could only recall the most celebrated russian church in petrograd. she must lose no time, for even barbara must not learn of her mission, and barbara might turn and come back to join her at any moment. "in the cathedral of st. isaac, toward the left and in the rear of the church at three o'clock tomorrow," nona murmured. and katja must have understood, for she went away at once. it was just as well, because at almost the same moment barbara returned to join nona, her arms full of queer-shaped packages, and looking happier than she had since their arrival in the russian city. chapter xiii _the next step_ the following afternoon it seemed to nona davis that all petrograd was a-glitter with onion-shaped domes. the russian priests explained that these domes were really shaped like folded rosebuds, symbolizing the church on earth that was to blossom in heaven. but to see them in this fashion required a russian imagination. however, the effect was very beautiful, and nona was glad to have her attention diverted, as she started out to find the cathedral of st. isaac. some of the domes were of blue, set with stars to represent the canopy of the sky. but nona knew that the central dome of st. isaac's was an enormous copper ball covered with gold and that its radiance could be seen at a great distance. she had had great difficulty in fulfilling her engagement with katja. at first she had tried to deceive barbara in regard to her intention, being fully determined to continue her search for sonya until she had discovered her; nevertheless, it did not seem worth while to trouble barbara while she had no actual information to go upon. but barbara would not be deceived. nona suggested that she wished to walk for several hours and feared the younger girl might become fatigued. in reply barbara assured her that there was nothing she herself so much desired as exercise, and as for growing tired, nona would the sooner be worn out, since she was the one who had been ill. afterwards, while there were other excuses for her departure which nona struggled to invent, all were equally useless. from the first barbara had guessed her plan. although she had seen nothing and knew nothing of nona's meeting with katja the day before, she had immediately guessed that nona's desire for a solitary excursion was in some way connected with her effort to find sonya valesky. and this effort the younger girl continued to oppose. so nona had finally departed, leaving barbara in tears over her obstinacy and foolhardiness. she was very unhappy, but what else was possible for her to do? had barbara been in the same need that sonya now was, surely no one could have persuaded her to turn her back upon barbara. katja was waiting and fortunately there were but a few other persons in the cathedral at the same hour. as quickly and as intelligently as she knew how, the old woman explained that sonya was in a civil prison in petrograd and was to be tried for treason within another week. katja had not seen her child, but had received a few lines in reply to a dozen letters which a friend had written for her. katja herself could neither read nor write. although nona could speak only a few words of russian, she had learned to read a little of the language with difficulty. now she managed to translate her friend's ideas, if not her exact words. sonya did not wish katja to try to see her nor to attempt to appear at the prison at the hour of her trial. nothing could be done for her release and katja would only be made the more miserable. neither was katja to let nona know anything of her whereabouts until after sentence was passed. then if katja could find the american girl she was to say farewell for sonya valesky. she was also to thank nona for her kindness and add that the acquaintance with her friend's daughter had brought sonya much happiness. standing with the crumpled sheet of paper in her hand, written by the woman who so soon expected to say farewell to the things that make life worth living, nona davis felt her own cheeks flush and her eyes fill with tears. how little had she really deserved the russian woman's affection, for how much she had distrusted her! well, nona again determined to do all that was possible now to prove her allegiance. as soon as she could get away from katja, nona secured a sleigh and drove at once to the house of the american ambassador. because her card represented her as an american red cross nurse she felt assured that she would be treated with every courtesy. this was perfectly true, although obliged to wait half an hour; finally one of the secretaries of the ambassador invited the american girl into a small office. she could not, of course, see the ambassador without a special engagement, but the secretary would be pleased to do whatever was possible. nona was both pleased and relieved. the secretary proved to be a southerner, a young fellow from georgia, who could not have been more than twenty-five years old. certainly it was far easier to tell the story of sonya valesky to him than to an older man or to one whose time was more valuable. nevertheless, when she had finished, although there was no doubt of the secretary's attention and interest, nona found him equally as discouraging as everybody else had been concerning sonya valesky's fate and any part which she might have hoped to play in it. there could be little doubt that sonya would be condemned to siberia. she was a political prisoner and would not be tried by a military court. her offense was spoken of as sedition, or as an infringement of the "defense of the realm" act. for sonya had been endeavoring to induce the russian soldiers to join her peace societies rather than to fight for their country. the young american secretary did his best to make the situation plain to nona davis. in england or france, under the same circumstances, sonya valesky might have escaped with only a short term of imprisonment or a fine. but this would not be true in russia. besides, it appeared that sonya was an old offender and that her socialist ideas were well known. it would be impossible for the american ambassador or any member of his staff to make the smallest effort in sonya's behalf. such an effort would represent an act of discourtesy on the part of the united states government, as if she were attempting to interfere with russia's treatment of her own subjects. there was one thing only which the young secretary could undertake in nona's cause. he would make an effort to have her allowed to visit her friend. if sonya's trial was not to take place for a week, it was just possible that the american girl might be permitted to see her. so nona was compelled to go away with only this small consolation. however, before leaving she secured the address of an american family in petrograd who might be willing to take her as a boarder. for nona realized that with her present plan she could not longer remain as a guest in the countess' house. then barbara had again to be reckoned with. it was early dusk when nona davis finally reached their apartment in the splendid russian house. barbara had just finished tea, but the tea things had not been sent away. because nona was evidently so tired and discouraged the younger girl comforted her with tea and cakes before beginning to ask questions. afterwards barbara insisted upon being told the entire account of the afternoon's experiences. nona must begin with her meeting with katja, her interview in the cathedral, then her visit to the house of the united states ambassador and finally the description of the place where she had engaged board before returning to her temporary home. although barbara was ordinarily much given to conversation and frequent interruptions of other people's anecdotes, she listened without comment until the other girl had finished. "we are both too tired to pack up our few possessions tonight, nona," she answered in conclusion; "but we can attend to them in the morning and then say good-by to the countess." nona was lying upon a divan with her yellow head sunk among a number of brown cushions, but she got half way up at barbara's words. "but i don't expect _you_ to leave here, barbara dear, to go with me," she protested. "i didn't engage board for anyone else. the house where i am to stay is shabby and not especially comfortable. i wouldn't have you leave this lovely home for worlds! i am sorry, you may be a little lonely without me. but i am hoping we may hear from mildred at almost any hour and then i'm sure the countess would be only too happy to have her take my place here. i expect mildred will be a distinguished character after having been chosen to nurse the great general alexis." "don't talk nonsense," barbara protested, in answer to the first part of her friend's speech. "of course, i am not going to let you wander off and live in a strange family by yourself." then barbara sighed. she was sitting on a small stool beside nona's couch, resting her chin on her hand and looking very childish and homesick. "of course, i know you have to do whatever you can for sonya valesky, nona," she agreed unexpectedly. "in your position i hope i would have the courage to behave in the same way. i have only made a fuss about things because i was worried for you, but i have always known you would not pay any attention to me. nobody ever does." although nona laughed and attempted to argue this point, barbara remained unconvinced. "oh, well, possibly dick or eugenia can sometimes be persuaded into doing what i ask, but never you or mildred," she concluded, and then sighed again. "if we could hear just a single word from mildred!" the next day the two girls moved to their new lodgings. their hostess was gracious enough, but made no protest when nona explained that she expected to be permitted to visit the russian prisoner within the next few days. the order to see sonya came sooner than nona expected. indeed, the two girls had only been in their new quarters for about thirty-six hours when the young secretary from the embassy called upon them. with him he brought the permit from the russian government. nona was to be allowed to visit the prison near the troitska bridge on the following day and to spend ten minutes with her friend. she must understand that a guard would listen to whatever conversation was held. also she must take with her nothing of any kind to present to sonya valesky. their interview would be closely watched. naturally barbara meade insisted upon accompanying nona. she knew, of course, that she would not be allowed to see the prisoner, nor had she the least wish to see her. but she could wait in some antechamber until the ten minutes passed and then bring nona safely back to their lodging place. for certainly the experience ahead of her friend would be a painful one, and although nona did her best to conceal her nervousness from the younger girl, barbara again was not deluded. when the two girls set out for the prison the next afternoon it would have been difficult to decide which one most dreaded the ordeal. but in truth the ordeal was in a way a mutual one. while she waited, doubtless barbara's imagination would paint as tragic a scene as nona might be obliged to go through with. it seemed to nona davis, after leaving barbara, that she walked down a mile or more of corridor. the corridor might have been an underground sewer, so dark and unwholesome were its sights and smells. it led past dozens of small iron doors with locks and chains fastened on the outside. finally nona's guard paused before one of these doors and then opened it. inside was an iron grating with bars placed at intervals of about six inches apart. the room it barricaded was six feet square and contained a bed and stool. there was one small window overhead, not much larger than a single pane of glass in an average old-fashioned window. but the light from the window fell directly upon the head of the woman who was seated beneath it. sonya valesky had not been told that she was to receive a visitor. so perhaps nona did appear like a sudden vision of a fra angelico angel, standing unexpectedly in the dark corridor with her hair as golden as a shaft of sunlight. sonya only stared at the girl without speaking. but nona saw that her friend's dark hair, which had been a little streaked with gray at their first meeting more than two years before, was now almost pure white. however, sonya did not look particularly ill or unhappy; her blue eyes were still serene. whatever faith in life she may have lost, she had not lost faith in the cause for which she must suffer. "don't you know me, sonya?" nona asked almost timidly, as if she were talking to a stranger. then the russian woman came forward with all her former dignity and grace. she was wearing a black dress of some rough material, but it seemed to nona davis that she had never seen a more beautiful woman. sonya was like a white lily found growing in some underground dungeon. she put her hands through the bars and took hold of nona's cold ones. "this is wonderfully kind of you, nona?" she said with the simplicity of manner that had always distinguished her. "i have wanted to know what had become of you and your friends. somehow information sifts even inside a prison in war times, and i have learned that general alexis gave up trying to hold grovno. you are on your way back home, i trust." nona could scarcely reply. it seemed so strange that sonya could be talking in such an everyday fashion, as if her visit were being made under ordinary circumstances. not a word did she say of her own sorrow or the tragedy that lay ahead of her. nona could only fight back the tears. "we are returning to france as soon as mildred thornton joins us in petrograd," she answered, and then explained that mildred had stayed behind at grovno. "but isn't there anything i can do for you, sonya?" nona added. "i shall certainly not leave petrograd until after your trial, and then if you are released you must come away with me." the older woman only shook her head. "i shall not be released, nona, so don't make yourself unhappy with false hopes. this is not my first offense against the government of russia. i have never believed in the things in which they believe, not since i was a little girl. i suppose i am a troublesome character. but after all, in going to siberia i am only following the footsteps of greater men and women than i can hope to resemble." sonya let go nona's hands and stepped back into her little room. from under her pillow she drew a small folded paper. "in going to siberia i forfeit all my estates, nona," sonya valesky explained when she came back. "but i have a small amount of money in the united states, as well as in my own country. perhaps the government may be willing to allow me to dispose of my property, although of course i can't tell. but i have made a will and had it witnessed here in the prison. if it is possible i want you to have half of the little i have left and katja and nika the rest. there would be no chance to leave it to the cause of peace in these days." nona received the little paper. "you won't be in siberia all your life, sonya, that i won't believe," she protested. "some day when this war is over the czar will pardon you. please remember that i shall never forget you and never stop trying to do what i can for your release. if i am allowed to have it, i will take care of your money until you are able to come to me." hearing a guttural noise behind her, nona davis now turned around. her guard was signaling that the time allotted for her visit was over. she was not able to kiss the older woman good-by, only to hold both her hands close for another moment and then to go away with her eyes so blinded with tears that she could not see. yet she never forgot the picture that sonya valesky made when she had a final glance at her. four days later a few lines appeared in the russian daily papers, stating that sonya valesky, a woman of noble birth, but at present a russian nihilist, had been condemned to penal servitude in siberia for life. she had been proved guilty of treason to the imperial government. chapter xiv _mildred's return_ on the same afternoon that nona and barbara read the news of sonya valesky's sentence, mildred thornton came to petrograd. her return was characteristic of mildred. it was a little past twilight and nona and barbara were in their shabby sitting room; they now shared the same bedroom in the new lodgings. nona had been crying, and in order to try and make her forget, barbara was reading aloud. she had received a package of books and magazines from dick thornton earlier in the day, but this was her first chance to look them over. although endeavoring to listen, in reality nona's attention was only pretence. her thoughts were with the russian woman whose life had been so strangely associated with her own. it seemed to nona that she had not realized how much she cared for sonya valesky until these last few weeks. she had become like an exquisite older sister whom she might possibly have had as a companion and friend. never had nona been more conscious of her own loneliness. it is true that she had been more or less lonely all her life, but this she had taken as a matter of course. now in these last few hours she had suddenly been overwhelmed by the thought. apparently their work as red cross nurses in europe was nearly over. at least, when mildred finally joined them, the three girls intended returning to france to spend a little time with madame castaigne and eugenia. then barbara and mildred would doubtless go back to their homes in the united states. barbara would be married in a short time and mildred would not wish to remain longer away from her mother and father. but nona had no home and no people to whom she might return. the girl was glad at this moment that there were no lights in their sitting room save the two candles which were directly behind barbara's book. she did not wish the younger girl to guess the extent of her depression. yet it was nona who first heard the knock at their sitting room door. quickly as possible she got up and walked forward to open it, not even attempting to smooth her hair or to wipe the traces of tears from her face. barbara did not glance from the page of her book, both girls were so convinced that it was only the woman who usually brought them their dinner at this hour. when nona opened the door, mildred took her by both shoulders and quietly kissed her. "mildred!" it was nona's exclamation that finally aroused barbara meade. but even then, although barbara rose to her feet, dropping her book on the floor, she did not move forward. she let mildred come and put her arms around her and kiss her on both cheeks. then mildred stood still in the center of the room and smiled at her two friends. "won't either one of you say she is glad to see me?" she asked, with a mixture of gayety and wistfulness. by this time barbara and nona were both embracing the newcomer at once, and at the same time attempting to remove her wraps. under her nursing coat mildred was wearing a long sable coat, suitable for a princess, but neither of the girls noticed it in the excitement of her arrival. "where did you come from? oh, mildred, what have you been doing all this time? i have nearly died of anxiety." barbara protested. "surely you could have gotten us some word, if only to say you were alive." mildred shook her head. "i couldn't, dear. i have come back to you the very first moment it was possible. but it is a long story. i can't tell you all at once. may i sit down?" at last nona and barbara had the grace to observe that mildred looked white and tired. "i arrived in petrograd about half an hour ago with general alexis and his staff and the russian maid who has been with us ever since we were left behind at grovno," she explained, when her friends had thrust her unceremoniously into their only comfortable chair. "i told general alexis that i must find you at once, so we drove to the united states embassy and they gave us your address. then they left me here. i am dreadfully hungry; can't we have something to eat before i finish my story?" "certainly not," barbara insisted, "or not until you have answered two or three more questions. for i am much more apt to die of curiosity than you are to perish of starvation. how long did you remain at grovno, and did the germans ever capture you? i suppose your general didn't die, if he escorted you to our humble door. but if he wasn't desperately ill, why did he have you stay so long in a position of such danger?" and barbara ceased to ask more questions simply because her breath had given out. at the same instant nona signaled a warning glance. mildred was almost fainting with exhaustion. in these last few weeks she must have passed through difficult experiences and naturally she could not tell them everything at once. "please go downstairs and ask that dinner be sent up, barbara," nona demanded. "and get soup or milk or something special; if not i'll make some beef tea for mildred on the alcohol lamp. mildred, suppose you put on my wrapper and lie down until after you have eaten, then we can talk as long as you have strength for." and the girls did talk until nearly midnight in spite of mildred's fatigue. she was perfectly well, only tired, she insisted, and greatly excited at seeing nona and barbara again. she had passed through events in these past few weeks such as few women have ever known. but of course mildred related what had taken place in a simple, almost matter of fact fashion. she was so little given to heroics, or to thinking of herself as a conspicuous personage. "yes, they had stayed on at grovno until almost the hour when the germans entered the old fortress. general alexis had been wounded, but had not considered his wound serious and would not desert his post until he had finally accomplished his purpose. for the last hour virtually only six persons had kept the german army from entering the fortifications: general alexis, colonel feodorovitch, two lieutenants and two private soldiers, although the russian physician, who had remained with his commander, had turned soldier toward the last." "but you don't mean that you continued inside the fort to the very end?" barbara demanded almost angrily. "i suppose you were forgotten." "i think i was at the last," mildred returned. "you see, at first when general alexis discovered that i was the red cross nurse who had been chosen to stay behind, he was angry and insisted that i leave at once. but by the time he learned of my presence, it was too late to find me an escort. besides, the doctor did not wish me to go. there was a russian woman, a kind of servant, who was also with us, and did the cooking, i believe, if we ever ate. anyhow, she stayed with me and looked after me when she could, so that i was never actually alone." "but mildred," nona asked, guessing at many details that her friend did not mention, "how did you finally get away at last? and have you come directly here from grovno? surely the fort did not hold out all these weeks." "no, we have been away from grovno nearly two weeks, i can't remember the exact passage of time very well," mildred explained, lifting her hands to let down the long braids of her heavy flaxen hair, and allowing the hairpins to drop girl fashion, carelessly into her lap. she was wearing nona's kimono, and it is always easier to talk confidentially with one's hair down, if one happens to have the mass that mildred had. the very weight of it was oppressive when she was tired. "yes, it was terribly interesting toward the last," she went on, "although i don't believe even then we were in great danger. general alexis is too wise to have permitted that. everything was in readiness; all the plans were made days beforehand for our getting away. the different regiments of private soldiers with their officers continued to march away from grovno, and so much ammunition was moved that i think almost no stores of any value were left. then the moment finally came for our own retreat." to barbara's intense irritation, mildred actually paused for an instant at this point in her story. but she continued almost immediately. "there was an underground passage outside the fort, leading all the way to the river. the seven of us at last left the fort together. by this time general alexis had almost to be carried, the pain from his wound had grown so intense. then every once in a while, as we went on, one of the soldiers would place a bomb in such a position that it would explode after we had gone. in this way the underground passage was wrecked, so there never was any possibility of the germans being able to follow us. when we reached the bridge over the river two motor cars were waiting for us. colonel feodorovitch, one of the lieutenants and the two private soldiers stayed to see that the last bridge over the styr was blown up. the other five, general alexis, his physician, and one officer and we two women started west in an effort to join the retreating regiments, who were to come up with a portion of the grand duke's army." "goodness, mildred thornton, what an experience you have been through!" nona ejaculated. "yet you talk as quietly as if it were almost an ordinary occurrence!" mildred shook her head. "it is not because i feel it an ordinary experience, nona, but because so much has happened i am overpowered by the bigness of it. really, when we got safely away from the fort, the battle, or at least my share in it, was only about to begin. we had gone a few miles into the country, when general alexis became desperately ill. unless he could have immediate attention his physician said there was no possible hope for his life." barbara had by this time slipped out of her chair and was sitting on the floor with her hands clasped over her knees, looking all eyes, and rocking herself slowly back and forward as a relief for her excitement. "but you brought your general back with you, mildred thornton, or you said you did. how on earth did you manage about him?" she interrupted. "that is just what i am going to tell you, because that explains where i have been and why i have not been able to let you hear from me. our russian doctor ordered our motor car stopped and we entered a russian house some distance from any main road. we purposely chose a house that had been deserted, and there we have been for two weeks, struggling to save the life of general alexis. of course, his wound had been more serious than he would admit. the wonder is that he is still alive!" "but he has recovered?" barbara inquired with her usual unsatisfied curiosity. "goodness, mill, what a heroine you will be, to have nursed one of the most famous generals in the allied armies and to have restored him to health. won't your mother be charmed!" naturally mildred smiled. the thought of her mother's pleasure in her distinction _had_ occurred to her several times in the last two weeks. "oh, of course i am glad to have had the honor, bab, because i too think general alexis a great man. he is perhaps the simplest man i have ever known, except my father, and i like him very much. only he has not recovered and i have not restored him to health. if general alexis had recovered he would never have come to petrograd, he would have rejoined his troops. but he was well enough to be moved and petrograd seemed the safest place for him at present. besides, i believe he wished to have an audience with the czar." barbara again rocked back and forth. "you say 'czar,' mill, just as if you were speaking of an everyday person. really, i believe you are the best bred girl i ever saw. position, wealth, no distinctions seem to excite you. you just take people for exactly what they are," barbara murmured, in reality speaking to herself. but nona overheard her. "you are quite right, bab," she agreed. "mildred does not know it, but she has taught me many a lesson on that subject since we came to europe. it would be a nicer world if everybody thought and acted as mildred does. but what has become of your general, mill? are you to go on nursing him or to see him again?" "no, to the first question, nona dear, and yes, to the second. now i am so tired i simply must go to bed. i told the doctor and general alexis that since he was better, i wanted to come to you. besides, i was sure that here in petrograd there would be so many cleverer nurses than i can ever hope to be. and i didn't want to stay at the winter palace with you girls here." "you mean," nona asked quietly, "that you were invited to be a guest at the czar's own palace and you declined?" mildred clasped her hands behind her head. "oh, i thought i told you. general alexis is to be at the winter palace while he is in petrograd. he is very close to the czar, i believe. as his nurse, of course i was asked to stay there with him; he is to have his physician and his aides as well as his servants in attendance. there was nothing personal in my being permitted inside the palace. some other nurse will take my place." "but the point is, mildred thornton, that you refused to stay under the same roof with the czar of all the russias. never so long as you live will your mother forgive you." the other girl flushed and laughed. "i hadn't thought of that, bab dear. please don't tell on me. but we are to be under the same roof with the czar some day for a few moments, all of us. general alexis said that he wished to have us presented to the czar and czarina, if it were possible to arrange. he seems to feel grateful to me for the little i was able to do. but please, bab, don't say that i refused to continue to nurse general alexis. i only asked that they get some one to take my place, who would be wiser." "did general alexis agree to a new nurse for that reason, mildred?" barbara demanded in her driest manner. but mildred was too tired for further conversation. "oh, he was kind enough to say that i needed a rest more than he required my services. am i to have a bed or the cot in this sitting room?" "you may have them _all_, mildred thornton!" barbara returned, getting up on her feet and then bowing until her forehead almost touched the floor. "any human being who is going to allow me to enter the presence of the czar and czarina, has got to be treated like royalty for the rest of her life." nevertheless, barbara kissed mildred good night. mildred whispered, "don't be a goose," and then at last was permitted to retire. chapter xv _the winter palace_ the next day nona found opportunity for confiding to mildred the fate of sonya valesky. she found mildred more deeply concerned than barbara had been. this was true because mildred had a different nature; it was easier for her to understand a temperament that would sacrifice everything to its dream, than for the more practical and sensible barbara. moreover, barbara was so much in love these days that she found it difficult to give a great deal of thought to other people. she struggled against the tendency, but it is ever the vice of lovers. finally, on thursday, mildred thornton received a note from general alexis inviting her and her two friends to come that afternoon at four o'clock to the winter palace. and although the three girls were americans, they understood that such an invitation was not in reality an invitation, but a command. for the czar and czarina had announced that they would be pleased to meet the three american red cross nurses. the meeting was to be informal, as these were war times and there were no court levees. indeed, the czar was only staying for a brief time at his palace before going to take command of his own troops. owing to the frequent russian defeats in the past few months, the czar had concluded that he must command his men in person in order to give them greater courage and steadfastness. the munitions of war, of which they had been sadly in need for several months, were now pouring in from japan and the united states. of course, in the excitement and nervousness due to such an important and unexpected occasion, the three red cross girls had the same problem to settle that attacks all women at critical moments: "what on earth should they wear to the presentation?" fortunately, under the circumstances there was but one answer to this question. they were invited to the palace as red cross nurses, they must therefore wear their red cross uniforms. since the three girls had almost nothing else left in their wardrobes, this was just as well. constant moving from place to place, with little opportunity for transportation, had reduced their luggage to the most limited amounts. yet assuredly they were as handsome and far more dignified on the afternoon of their appearance at the winter palace in the costumes of american red cross nurses, than if they had been appareled in the court trains and feathers of more gala occasions. mildred always looked especially well in her uniform. she was less pretty than the other two girls. but for this very reason her dignity and the sense of serenity that her personality suggested showed to best advantage in the simple toilette of white with the red cross insignia on the arm. however, over her uniform mildred wore the magnificent sable coat in which she had appeared at her friends' lodgings in petrograd. this afternoon, in spite of her excitement over what lay ahead of them, barbara did not allow the coat to pass unnoticed a second time. "for goodness' sake, mildred, where did you get that magnificent garment?" she demanded, just as they were about to go downstairs to get into their sleigh. "you owned a very nice coat when we left you behind in grovno, but some fairy wand must have changed it. this is the most wonderful sable i ever saw." mildred flushed and then laid her cheek against the beautiful, soft brown warmth of her furs. "it is time you and nona were speaking of my grandeur," she declared. "you see, in getting away from the fort at the last i stupidly left my own furs behind; indeed, i don't know what became of them. general alexis noticed that i was cold almost immediately. somehow, after he began to get stronger, he managed to have this coat brought to the country house where we were staying. then just before we started to petrograd he presented it to me. of course, i did not feel that i ought to accept it and insisted i could not. but general alexis said that he had received so much kindness from me, he thought it very ungenerous of me to make him altogether my debtor. i didn't know what to do. do you think it wrong to accept it, bab? somehow i did not know how to continue to refuse." as barbara was just going into her bedroom at this moment, she made no reply. nona was more reassuring. "of course it was all right, mildred, or at least i suppose it was if general alexis insisted, and you had done a great deal for him." then nona followed barbara. barbara was standing perfectly still in the center of the room and apparently thinking with all the concentration possible. "i wonder if this general alexis is more fond of mildred than he would be of any nurse who might have cared for him?" barbara murmured. then she shook her head. "that was an absurd suggestion on my part and mildred would not like it. i am sorry," she said. at the door of the winter palace, after the girls had passed beyond the servants and the detectives who watch every human being permitted to approach their imperial majesties, the three american girls were ushered into a reception room. except for the fact that there were more paintings on the walls, the room resembled other similar chambers now left on exhibition at versailles or the louvre in paris. however, the girls had little time for investigation, for almost at once general alexis entered the room to greet them. he was accompanied by a lieutenant who was his aide. to nona davis' surprise, the young man proved to be lieutenant michael orlaff, whom she had not seen since the afternoon when she had walked to the fortress with him and confided the news of sonya valesky's arrest. after a few moments of general conversation a man servant, wearing an elaborate uniform, announced that general alexis and his guests might walk into the czar's private sitting room. naturally this was a very unusual proceeding, but war times had changed the manners of courts as well as other places. moreover, general alexis was a personal friend of the czar's, so far as a czar may ever have a friend. in any case, he was one of his most trusted generals. this reception to the american red cross girls was entirely due to the fact that general alexis had declared mildred thornton's courage and devotion had saved his life. but of this she was not yet aware. the czar and czarina were not decorating gilded thrones as one sees them in portraits or paints them in one's own imagination. indeed, they were seated in chairs, but rose as any other host and hostess might when their guests came into the room. they were not alone, however, for beside the guards stationed outside their door, two of them kept always within a short distance of the czar himself. the czarina was a beautiful woman, tall and dark, but looking infinitely sad. the girls could not but remember having heard how frequently she suffered from a melancholia so severe that it was almost akin to an unbalanced mind. she now murmured a few words to the three girls and then reseated herself. barbara hoped profoundly that the distinguished audience would soon be over. of course, this meeting of the czar and czarina was perhaps the most extraordinary honor that had yet been paid to any american red cross nurses in europe. but like other honors, it carried its discomfort. for barbara had not the faintest idea what she should do or say, when she should stand up and when sit down. she had never imagined herself a large person before, but now she felt so awkward that she might have been a giant. yet really there was but one thing for her to do: she must merely keep still and watch what was taking place. actually the czar, nicholas ii, was talking pleasantly with mildred thornton, and mildred was answering with her usual quiet dignity. the czar looked older than barbara would have supposed from his pictures. but then the war may have aged him. his close-cropped brown beard with the tiny point was turning gray. and he had large, full and, barbara thought, not particularly intelligent eyes. at this moment he moved toward a small table and picked up what appeared like a medal. barbara eyed it curiously. she could not hear what the czar was saying. but she saw mildred turn suddenly white and appear to protest. then the two men, general alexis and the czar, actually smiled at her. the next moment the czar pinned a cross on mildred's white dress. without realizing what she was doing, barbara pressed closer until she stood in front of nona and lieutenant orlaff. this time she distinctly heard the czar say: "i take pleasure in presenting you, miss thornton, with the cross of st. george, which is only awarded for special bravery. only one other woman has been presented with the cross of st. george since the outbreak of this war. she is madame kokavtseva, a colonel of the sixth ural cossack regiment, who has twice been wounded while leading her men. she is called our 'russian joan of arc.' but there is a courage as great as leading troops to battle. this valor, it seems to me, you showed in remaining to the last at the ancient fortress of grovno to care for a great soldier who was not even your countryman. in my own name and in the name of my country, i wish to thank you for your service to general alexis." then barbara observed mildred flush a beautiful, warm crimson, and stammer something in response. almost immediately after they were again standing outside in the big antechamber. afterwards general alexis and lieutenant orlaff and several of the palace servants showed the three girls over certain portions of the palace that could be exhibited to visitors. on the desk in the hall was an ikon, carefully preserved under glass, which was said to have been painted by st. luke. however, in spite of their honors, as soon as possible the three girls were glad to return to their lodgings. yet mildred promised that they would allow general alexis to send his sleigh to them the following day. the great general looked haggard and worn, but appeared to be quickly recovering his strength. indeed, barbara afterwards assured mildred that she considered him extremely good looking and not half so old as she had supposed. chapter xvi _the unexpected happens_ one afternoon a short time after the visit to the winter palace, general alexis and lieutenant orlaff came to the girls' lodgings to have a drive in the sleigh with them. it was a cold, brilliant afternoon, and they were to undertake a more interesting excursion than usual. nevertheless, barbara meade refused to go. there were letters which she must write, she pleaded. however, this was not barbara's real reason: that fact she kept in her own head. both mildred and nona she assisted to get ready, insisting that they both dress as warmly as possible, no matter how stuffy they might feel before starting. "you are both blondes and a blonde is never so homely as when she is cold," she added sententiously, "for her face is much more apt to get blue than red, except the end of her nose." mildred had purchased a lovely fur hat to match her sable coat. and in spite of her poverty nona had been unable to resist a set of black fox. furs were so much cheaper in russia than in the united states that it really almost seemed one's duty to buy them. when general alexis' sleigh arrived, barbara would not even go downstairs to see the others start. but she managed by pressing her nose against the window to observe that the arrangements for the drive were satisfactory. the sleigh was a beautiful one, built of mahogany, and the pair of horses wore real silver mountings on their harness. a driver, in the imperial livery, sat upon the front seat with a man beside him, who acted as a private guard for general alexis, although he wore citizen's clothes. there was far less danger of anarchy in russia during war times; nevertheless, men in public positions in russia were always watchful of trouble from fanatics. therefore, general alexis and mildred were together in the middle seat, while nona and lieutenant orlaff occupied the one back of them. then the sleigh started off so quickly that it had disappeared before barbara realized it. afterwards, with feminine inconsistency, she turned back into their small sitting room, frowning and sighing. "i do wish i had gone along, after all. there wasn't any place for me, except to sit either between mildred and general alexis, or nona and her russian lieutenant. then nobody would have had a good time. still, perhaps i should have stuck close to mildred; she is almost my sister. and though mrs. thornton might be pleased, judge thornton and dick would be wretched. russia is so far away and so cold." then barbara made no further explanation, even to herself, of her enigmatic state of mind, but fell to writing letters as she had planned. some thought she devoted to what she should write dick about his sister's friend, the distinguished russian general. but whatever she planned sounded either too pointed or else had no point at all. so she merely closed her letter by explaining that the others had gone for a ride and that general alexis appeared extremely grateful to mildred for her care of him in his illness. she also mentioned that she personally liked the distinguished soldier very much and that he was not nearly so foreign as one might expect. this was not a sensible statement, for general alexis could scarcely have been more of a russian than he was. a foreigner, of course, simply is an individual who belongs to another country than one's own. presumably an american is equally a foreigner to a european. what barbara actually meant was that general alexis was not unlike the men to whom she had been accustomed in the united states. he had the courtesy and quiet dignity of the most distinguished of her own countrymen. there was nothing particularly oriental about him or his attitude to women. the truth is that barbara did not appreciate the fact that general alexis was too cosmopolitan to show many of the peculiarities of his race. he had seen too much of the world and studied and thought too deeply. besides, he was a man of real gentleness and simplicity. as mildred rode beside him, she too was wondering why she felt so at ease with so great a person. why, at home, in new york society, she had always been awkward and tongue-tied with the most ordinary young man worthy of no thought. now she was telling general alexis the entire story of sonya valesky as she might have told it to her own father. and she felt equally sure of his sympathy and understanding. general alexis would, of course, have no political sympathy with sonya's ideas. he was a soldier devoted to his czar and his country, while in his opinion sonya could only be regarded as mistaken and dangerous. but mildred knew that he would be sorry for sonya, the woman, and sorry for them as her friends. so she described their original meeting on board the "philadelphia," and the suspicion, then wrongfully directed against sonya, who was at that time using the name of lady dorian. afterwards she told of sonya's appearance at the sacred heart hospital and her work there. last of all, of their unexpected coming together in russia and of the peculiar bond between nona davis and the russian woman. at the beginning of her conversation with general alexis, mildred had no idea in mind, except to tell the story that had been weighing heavily upon her since nona's confidence. ever since she had seen the picture of sonya, as nona had last seen her, the beautiful woman with her too-soon white hair and the haunting beauty of her tragic blue eyes. she, a woman of rare refinement and not yet forty, to spend the rest of her life working among the convicts in siberia. it was as if she were buried alive! suddenly it occurred to mildred that she might ask the advice of general alexis. she did not believe it possible that anything could be done for sonya valesky now, after her sentence had been passed. but still it would be well to feel they had tried all that was possible. "you don't think, general, that there is anything that could be done to have sonya valesky pardoned, do you?" she inquired, with unconscious wistfulness. "you see, my friend, nona davis, wants so much to take madame valesky back to the united states with her. then neither she nor her ideas would be of any more danger to russia. nona says madame valesky is much broken by her illness and confinement. she had a terrible attack of fever only a short time before. probably she won't live very long, if she is taken to siberia." then, to hide her tears from her companion, mildred turned her head aside. general alexis seemed to be staring at her very steadfastly. but fortunately the beauty of the landscape surrounding them gave her an excuse for the movement. they had crossed the nicholas bridge and were driving out among the parks and estates that cover the small islands, set like jewels among the white fastness of the river neva. here and there the river was solid ice, in other places the thin ice was decorated with a light coating of snow. the handsome private homes of petrograd are situated in these island suburbs. beautiful trees and lawns come down to the water's edge. but today they too were snow sprinkled and most of the homes were closed. mildred attempted to pretend that her attention had been attracted by one of these houses, built like a glorified swiss chalet. but general alexis continued to gaze at the side of her cheek and mildred was painfully conscious that the tears might at any moment slide out of her eyes. "you care very much about this woman, this sonya valesky, miss thornton?" general alexis inquired. "you say that she is a friend of yours and that it will bring you great distress if she must suffer the penalty of her mistakes? i do not wish you to leave russia in unhappiness." mildred slowly shook her head. had she been almost any other girl, she would have seen nothing to deny in her companion's last speech. but mildred had the spirit of entire truthfulness that belongs to only a few natures. "no, i cannot say that madame valesky is exactly _my_ friend," she answered slowly. "i do not know her very well, but i think i should care for her a great deal if we could know each other better. perhaps she was altogether wrong; anyhow, i do not think she should have attempted to persuade the russians not to fight for their country at a time like this. yet when one has seen the horrible, the almost useless suffering that i have seen in these few years i have been acting as a red cross nurse, well, one can hardly condemn a human being who believes in peace. still, madame valesky is in reality more nona's friend than mine." pausing abruptly, mildred again turned her face to look at the soldier beside her. she had been tactless as usual in thus expressing her feelings about peace to a man who was a great warrior. but general alexis did not appear angry. indeed, there was no disagreement in the expression of his eyes, it was almost as if he too felt as mildred did. besides, his next words were: "i too appreciate what you feel, miss thornton, and i too am sorry for this sonya valesky. war is a great, a terrible evil, and there was never a time when the world so realized it as it does now. it is my hourly prayer that, after this vast bloodshed, war shall vanish from the face of the earth. but this will not happen if we give up the fight while we are in the thick of it. so madame valesky was wrong, so wrong that i might think she deserved her fate, if i did not feel her more mistaken than wicked." general alexis paused and his face grew suddenly lined and thoughtful, as mildred had seen it in those days at grovno. of what he was thinking the girl did not dream, but neither would she wish to have intruded upon his train of thought. so she sat quite still with her hands folded under the heavy fur rug and her gray-blue eyes fastened on the snow-covered landscape. mildred had grown handsomer since her coming to europe. she would never be beautiful in the ordinary acceptance of the term. but she was the type of girl who becomes handsomer as she grows older, when character which makes the real beauty of a woman's face had a chance to reveal itself. already a great deal of her awkwardness and angularity had disappeared with the self-confidence, or rather more the self-forgetfulness which her work had given her. her eyes had a deeper, less unsatisfied expression and her always handsome mouth more humor. for her own experiences and the friendship with the three other american red cross nurses had taught her to see many things in truer proportion. "miss thornton," mildred's attention was again aroused by her companion, "i want to tell you something, but i want you to promise me you will not have too much hope in consequence. i have been thinking of this sonya valesky. i believe i can remember her father, or if not her father himself, at least i knew him by reputation. he did not share his daughter's views, but was the faithful servant of the present czar's father. moreover, the czar is my friend, so i mean to tell him the story of sonya valesky and see if he will pardon her. she must, of course, leave russia, perhaps never to return." general alexis had been in a measure thinking aloud. but now mildred's sudden exclamation of happiness made his eyes soften into a look of kindliness that again reminded the girl of her father. "but, my child, you must not hope too much," he remonstrated. "the czar may not feel as i do about your friend. after your service to me there is little you could desire which i would not wish to give you." one would never have thought of general alexis as a great soldier at this moment. the heavy lines of his face had gone. there was no sternness about his mouth. his eyes, which were so surprisingly blue because of his other dark coloring, gazed at mildred's until for an instant she dropped the lids over her own, feeling embarrassed without exactly knowing why. the next moment she looked directly at the man, whom she felt sure was her friend, in spite of the differences in their ages, their rank and their countries. "general alexis, i am going to ask you to do me a favor--no, i don't mean about sonya this time. i shall be more grateful than i can even try to say for that kindness. but this is something which does not concern anyone except just you and me. will you never in the future speak or think of the service which you are good enough to say i have rendered you." actually, mildred was now twisting her hands together in the old nervous fashion which she thought she had overcome. "it is difficult for me to say things," she went on, "but i want you to know that the greatest honor i shall ever have in my life was the privilege of nursing you. if i did help make you well, why i am so happy and proud the favor is on my side and not yours." and mildred ended with a slight gasp, feeling her cheeks burning in spite of the cold, so unaccustomed was she to making long speeches or to revealing her emotions. "miss thornton," general alexis returned. then instead of finishing his sentence he leaned over and touched his coachman. "stop the sleigh for a moment. we are growing cold. it will be better for us to walk for ten or fifteen minutes and then come back to the sleigh." again he spoke to mildred. "you will come with me for a little?" he asked. "it will be wiser for you not to grow stiff with sitting still." afterwards he said something to lieutenant orlaff, to which he and nona agreed. five minutes later mildred was walking across the snow toward the river, with her hand resting on general alexis' arm. she was colder than she had imagined and it was difficult to walk over the icy and unfamiliar ground. but suddenly she stopped and gave an exclamation of surprise and delight which was almost one of awe. she and general alexis were alone. nona and lieutenant orlaff had walked off in an opposite direction. but mildred now beheld the sun setting upon the russian capital. beneath, the world was pure white, and above, the sky a glory of orange and purple and rose. between the two, suspended like giant fairy balls, were the great domes of petrograd's many churches. "i shall never, never forget that picture so long as i live. it will stay with me as my vision of petrograd long after i have gone home to my own country," mildred said simply. then she stopped in her walk and held out her hand. "thank you for this afternoon." general alexis did not release the girl's hand. instead he lifted it to his lips and kissed it, although the hand was covered with a heavy glove. then he smiled at mildred almost boyishly. "i want to say something to you, miss thornton, which i suppose a woman does not really mind hearing, no matter to what country she belongs or what her answer may be. in these weeks i have known you i have come to care for you very deeply. i am old enough perhaps to be your father. i have said this to myself a hundred times and that it ought to make my feeling impossible. it has not. naturally i understand that my age may make it impossible for you to return my affection, but it has not made the difference with me. i love you, mildred. i have known many women, but have never met one so fine and sweet as you. it is the custom of your country when a man cares for a woman to tell her so, is it not, or perhaps i should have written first to your father?" general alexis' manner was so naïve, almost as if he had been a boy instead of one of the most distinguished men in europe. mildred could almost have smiled if she had not been so overwhelmed by his speech. was general alexis actually saying that he was in love with her? no one had ever proposed to her in her life and she had never expected that any one would care sufficiently. but that the words should come from the man whom she felt to be a genius and a hero! no wonder mildred was speechless for a moment. "general alexis, i have never dreamed of anything like this. i only hoped at the most that you were my friend," she answered a little later. "really, i don't know--i can't say how i feel. i appreciate the honor, but russia is so far away, and my father----" "yes, i know," general alexis interrupted. "do you not suppose i have thought over all those things? until this war is past i shall not even ask you to become my wife. my life belongs to my country and i would not have you alone here in a foreign land. all i ask is that i may write you and some day in happier times may i come to see my american friend?" mildred could only nod and let general alexis keep tight hold of her hand, while a sense of the warmth and sweetness of the affection of a big nature slowly enveloped her. then, as they walked back to the sleigh in silence and continued in silence almost all the way back to the lodgings, mildred could only keep thinking how much her father would like general alexis. once she smiled, because her next thought was how immensely pleased and impressed her mother would be. it seemed impossible that the plain and unattractive mildred could have captured so distinguished an admirer. late that night, as she lay awake, nona davis' voice suddenly broke the stillness. the two girls were in the single bedroom, barbara occupying a lounge in the sitting room. "there is something i want to tell you, mildred. the strangest thing happened to me this afternoon. lieutenant orlaff proposed to me. why, i scarcely know him at all, but he says that is not necessary when a foreigner meets an american girl," nona confided. "you--why, nona!" mildred faltered, too surprised for the moment to answer intelligently, because her friend's speech so oddly fitted into her own thoughts. "did you accept him?" it was dark in the room, and yet mildred could see that nona had risen half way up in bed. "my gracious, no!" she ejaculated. "in the first place, i don't care for him at all, and in the second, i just want to get hold of my dear sonya and return home to the united states. if your general does have her pardoned i shall say prayers for him every night of my life. funny, but i believe i am afraid of russia, even though i am half russian. still, my mother did prefer to come to america to live. i simply couldn't bear living in russia always, could you, mildred?" nona ended, as she again dropped back on her pillow. but mildred only answered, "i don't know," which was not in the least conclusive. chapter xvii _the departure_ four days later the three american girls left petrograd. this was sooner than they had expected to leave, but a desirable opportunity arose for them to get safely across the continent and into france. the journey was a long and tiresome one, as they had to cross the northern countries of finland, sweden and norway until finally they were able to reach holland, and thence journey to england and france. but it was not possible to make the trip in any other way, since all of southern europe was engaged in active fighting. however, the red cross girls did not travel alone. sonya valesky went with them. at general alexis' request the czar had pardoned her, but she was an exile from russia forever, never to return at any future time. fortunately for the imprisoned woman, her reprieve had come before her sentence had time to be carried out. she was brought directly from the prison, where nona had once visited her, to the lodgings where the american girls were making ready to depart. if sonya regretted the terms of her pardon, she showed no signs of sorrow. but she was strangely quiet then and during the long, cold trip across the continent. in a measure she seemed to have been crushed by the weeks of solitary confinement in the russian jail with the prospect of siberia ever before her. often she would sit for hours with her hands crossed in her lap and her eyes staring out the window, without seeming to see anything in the landscape. one could scarcely imagine her as a woman who had devoted her life to traveling from one land to another, trying to persuade men and women to believe in universal peace. yet she was sincerely grateful and appreciative of any attention of affection from the three american girls who were her companions. and after a short time barbara and mildred were almost as completely under the spell of this grave woman's charm, as nona had grown to be. moreover, the girls felt that she had not yet recovered from her illness, because of the hardships following it. after a few weeks or months in the beloved "farmhouse with the blue front door" perhaps she would become more cheerful. for it was toward the chateau country of france that the three american girls were again traveling. the little house where they had once lived for a winter had been captain castaigne's wedding gift to eugenia. since eugenia was away nursing in a hospital she had offered her home to her friends. madame castaigne had also insisted that they come to her at the chateau; nevertheless, the girls had chosen the farmhouse. the countess was no longer young, and still had no servants save old françois. the work of entertaining four guests, and one of them a stranger, would have put too great a tax upon her. moreover, eugenia would undoubtedly come back for a while to be with her friends and would naturally stay with her mother-in-law. the girls also hoped that captain castaigne might be spared for a short leave of absence. however, in order that the countess amélie should not be wounded, or feel that the girls no longer cared to be with her, barbara had written to say that she would stay at the chateau whenever the countess wished her society. certainly the trip from russia into france during war times was a difficult one. the girls believed that they could not have made it, except that now and then they stopped for a day or more to rest. on these days barbara and nona used to spend at least a few hours in sightseeing, no matter what their fatigue. now and then mildred would go with them, but never sonya. occasionally nona would urge her, saying that the exercise and change of atmosphere would be good for her. but sonya used always to plead fatigue or a lack of interest. finally she confessed frankly that she had seen most of these cities and countries before, and in some of them was fairly well known. therefore it might be safer and happier for all of them if she remained quietly in whatever hotel they happened to be staying. yet sonya appeared almost as anxious as her three companions to reach france and the "farmhouse with the blue front door." this, of course, was because the three girls had talked of it so continuously and the longed for meeting with eugenia again. for somehow, although the farmhouse was in a war-stained country, its name suggested quiet and a brooding peace. nevertheless, several times, after mentioning eugenia's name, nona had observed sonya's face flush and the expression of her eyes become almost apologetic. at first she was unable to understand this and then she remembered. in the early days eugenia had not liked their friendship with the woman who was then calling herself lady dorian. indeed, in eugenia fashion she had frankly stated this fact to the older woman. now how much less might she care for their intimacy with the exiled russian. yet sonya was going as an uninvited guest to eugenia's home. there had been no time to ask permission. it was true barbara had written the entire story to eugenia as soon as sonya valesky was released from prison. but one could not tell whether the letter would reach france as soon as the four travelers. nona felt that she would have given a great deal to have assured sonya of eugenia's welcome, but she was nervous over the situation herself. of course, eugenia would be kind to the exiled woman and offer her hospitality and care. but eugenia had rigid views of life and was not given to concealing them. it was more than possible that she might let sonya know of her disapproval. moreover, she might object to nona's own championship of sonya and to her purpose to return with her to the united states and there make their future home together. of course, no views of eugenia's would interfere with this intention of nona's. but the younger girl would be sorry of eugenia's disapproval, since she too had learned to have the greatest affection and admiration for the oldest of the four american red cross girls. however, there was nothing to do except to wait and meet the situation when the time came. actually it was a month between the day of leaving petrograd and the day when the four travelers arrived in southern france in the neighborhood of the chateau d'amélie. but this was because the girls and sonya had spent some little time in london before attempting to cross the channel. london was a delightful experience for the three american red cross girls. in some fashion the story of their varied service to the allied cause had reached the london newspapers. for several days there were columns devoted to their praise. later, invitations poured in upon them from every direction. mildred was most conspicuous, since the story of her presentation by the czar with the cross of st. george was copied from the russian newspapers into the english, and must have ultimately reached the united states press. but the girls were not thinking of themselves or their work. they simply gave themselves up to the pleasure of meeting delightful english people and being entertained by them. sonya would not go about with them, but appeared stronger and more content, so there was no point in worrying over her. one of the english women, who was again gracious to the three american girls, was the countess of sussex, at whose home they had spent a week-end on their first arrival in england several years before. once more she invited them to her country home, but this time it was impossible for the girls to accept her invitation. however, nona recalled her meeting in the old rose garden near the gardener's cottage with lieutenant robert hume. she also thought of lieutenant hume's last letter telling her that he had been sent back to england as an exchanged prisoner because of his health. but when nona inquired for the young english lieutenant, the countess' expression checked further curiosity. suddenly she appeared very unhappy and distressed. "robert is not in england," she said hastily. "he has been sent away to try to recover, but we do not dare hope too much." at the moment nona did not feel that she had the courage to ask where the young man had gone nor from what he was trying to recover. actually it was one afternoon in late february, when the three red cross girls and sonya came at last to the village of le pretre, near the forest of the same name. there they found old françois awaiting them in a carriage that must have belonged to the second empire. it was toward twilight and on a february afternoon, yet after the cold of the northern countries where the girls had been for the past winter, the atmosphere had the appeal of spring. it was not warm, yet there was a gentleness in the air and a suggestion of green on the bare branches of the trees. françois drove them in state to the little "farmhouse with the blue front door." but this afternoon the door was standing open and on the threshold was madame, the countess, with both white hands extended in welcome. she wore the same black dress and the same point of lace over her white hair. and by her side stood monsieur le duc, more solemn and splendid than ever and as gravely welcoming of his guests as the countess herself. madame explained that eugenia had been unable to leave the hospital to be at home to greet her friends, but hoped to see them in a few days. in the meantime they were to feel more than welcome in the farmhouse and in the old chateau, when they cared to come to her there. then the countess said good-by and allowed françois to take her home. she knew that her guests were weary and her courtesy was too perfect to permit herself the privilege of a longer conversation, no matter how much she might be yearning for companionship. the little house itself was warm and light with welcome. there was a fire in the living room and the four beds upstairs smelled of lavender and roses. the girls took their old rooms, except that sonya was allotted the bedroom that had once been eugenia's. chapter xviii _a poem and a conversation_ not the next day, but the one following, barbara and mildred walked over to the old chateau together. nona did not go with them, as sonya did not appear to be well and she did not wish to leave her. so she sent a message of explanation to the countess amélie, saying that she hoped to be able to call upon her very soon. it chanced that sonya did not know of nona's decision. she was lying down when the girls went away and believed she had the little house to herself. really she was not ill, only tired and perhaps happier than she had been in a long time. it is true that she had confessed herself defeated and that there was no longer any illusion in her own mind. perhaps so long as she lived, war and not peace would flourish upon the earth. but the world learns its lessons in strange and dreadful ways and perchance peace might be born in the end from the horror and waste of bloodshed. by and by, when she felt more rested, sonya got up and went down into the old dining room of the farmhouse, which the girls had made into their living room. there was a possibility that the fire might be dying out and it would be wise to replenish it. to her surprise sonya discovered nona curled up in a chair by the window, reading. the older woman no longer wore black; it had become too depressing in a continent where more than half of the women were in mourning. she had on a simple frock of a curious russian blue, made almost like a monk's cowl, with a heavy blue cord knotted about her waist. nona stared at her friend for a moment in silence. it was curious that whatever costume sonya valesky wore seemed to have been created for her. nona recalled the beauty of her clothes in their first meeting on shipboard, yet they held no greater distinction than this simple dress. well, perhaps personality is the strongest force in the world and sonya valesky's distinction, whatever her mistakes, lay in this. she now walked across the room and put a few of françois' precious pine logs on the fire. at this nona stirred. "don't trouble to do that, sonya; i meant to in another minute. i thought you were ill upstairs." sonya shook her head. "i am not in the least ill and you are please to stop worrying about me, nona. i thought you had gone with your friends to the chateau. what has kept you at home?" the younger girl answered vaguely, not caring to confess her real motive, since her companion would have been distressed by it. "if you are all right, sonya, suppose you stay down here in the living room with me. i have just found a wonderful poem in an american magazine which i meant to save to read to you. somehow i think it may comfort you. for it shows that there is a big design in this old universe, which works itself out somehow, in spite of all the tragedies and failures of human beings." in a big chair in the half shadow sonya sat down, folding her hands together loosely in her lap. it was a fashion which had come to be almost a habit with her recently. curious that it should express a kind of resignation! nona began reading at once. "the poem is called 'at the last' and is by george sterling, a californian, i believe. "now steel-hoofed war is loosened on the world, with rapine and destruction, as the smoke from ashen farm and city soils the sky. earth reeks. the camp is where the vineyard was. the flocks are gone. the rains are on the hearth, and trampled europe knows the winter near. orchards go down. home and cathedral fall in ruin, and the blackened provinces reach on to drear horizons. soon the snow shall cover all, and soon be stained with red, a quagmire and a shambles, and ere long shall cold and hunger dice for helpless lives. so man gone mad, despoils the gentle earth and wages war on beauty and on good. "and yet i know how brief the reign shall be of desolation. but a little while, and time shall heal the desecrated lands, the quenchless fire of life shall take its own, the waters of renewal spring again. quiet shall come, a flood of verdure clothe the fields misused. the vine and tree once more shall bloom beside the trench, and humble roofs cover again the cradle and the bed. yea! life shall have her way with us, until the past is dim with legend, and the days that now in nightmare brood upon the world shall fold themselves in purples of romance, the peace shall come, so sure as ripples end and crystalline tranquillity returns above a pebble cast into a pool." when nona had finished neither she nor her companion made any comment for a moment. yet when the girl looked across at the older woman for her opinion, she discovered that sonya's cheeks had flushed and that her eyes were shining. "thank you, nona; i shall not forget that," she then said, repeating to herself, "'the peace shall come, so sure as ripples end.' i suppose the trouble is we have not faith and patience enough to believe that love and peace must triumph before god's plan can be worked out." then sonya got up. "come, nona," she suggested. "don't you think it would be more agreeable to take a walk. it is really a lovely afternoon and i've some things i wish to talk to you about. besides, i want to see the woods you girls have told me of." it was delicious outdoors and nona and sonya both forgot their serious mood of a little while before. one could not be always serious even in war times in so lovely a land as southern france. no wonder the french nation is gay; it is their method of showing their gratitude for the country that gave them birth. finally the woman and girl reached the pool in the woods which nona had once named "the pool of melisande," and eugenia had afterwards called "the pool of truth." however, since in maeterlinck's play melisande was seeking the light in the depth of the water, perhaps after all the two titles had almost a similar meaning. anyhow, by the pool sonya chose to make a confession. "do you remember, nona, once long ago, or perhaps it just seems a long time to me, you and i met a colonel dalton, an officer in the british army whom i had known before. i think i promised then to tell you of my previous acquaintance with him. i had almost forgotten." nona slipped her arm through her companion's. "don't tell me if you had rather not. we will both have a great deal to learn of each other when we go back to the united states to live together." sonya smiled. "there is no use waiting. i have never even told you, nona, whether or not i am married. you see, i am often called madame valesky in russia, but that is only a courtesy title. i have never married. the fact is, i once lived in england for some time and was engaged to colonel dalton. i think we cared a good deal for each other, but he was a soldier and we did not approve of each other's views of life. so by and by our engagement was broken off, which was probably the best thing for us both." "has colonel dalton ever married?" nona inquired inconsequentially. her companion shook her head. "really, i don't know. suppose we walk on now to the hut where your little french girl nicolete once lived." when the two friends reached the hut, nona davis exclaimed in amazement: "what on earth has happened? why, our hut isn't a hut any longer; it is a charming little house with some one living in it. i am going to knock and see who it can be. french people are so courteous, i am sure they won't mind telling me." nona knocked and the next moment the door was opened by a young french woman. for an instant they stared at each other, then kissed in a bewilderingly friendly fashion. "why, nicolete, i can't believe my own eyes!" nona protested. "what are you doing back here in your own little house, only it is so changed that i would scarcely have recognized it." nicolete's dark eyes shone and the vivid color flooded her face. "i am married," she explained. "you remember monsieur renay, whom mademoiselle barbara named 'monsieur bebé?' well," nicolete laughed bewitchingly, "he is my husband." "and is he----" nona asked and hesitated. nicolete shook her head. "he can tell the light from the darkness, and now and then can see me moving in the shadow. some day, the doctors say, his sight may be fully restored. he has seen the best specialists. madame eugenié sent us both to paris. she it was who made us a home here in the woods out of the old hut, so that my husband might have the fresh air and grow strong to aid his recovery." "madame eugenié," it was a pretty title and one that eugenia would probably always have in this french country, which had so long known the old countess as madame castaigne. when barbara and mildred returned from the chateau nona sincerely hoped they would bring news of eugenia's arrival, since she was growing more than anxious to see her again. chapter xix _the reunion_ in truth, barbara and mildred were having a delightful afternoon at the chateau d'amélie. when they arrived, solemnly françois invited them into the old french drawing room they so well remembered. but here, instead of the slender, tiny figure of the old countess appearing to greet them, a tall, dark young woman came forward, whose hair was wound about her head like a coronet. "eugenia!" barbara exclaimed, and straightway shed several tears, while eugenia and mildred laughed at her. then the three girls went over and sat down on the same louis xiv sofa that two of them had once occupied with young captain castaigne, on their first visit to the chateau. this time eugenia took the place of honor in the center, while each hand clasped one of her companions. "henri and i arrived just an hour ago," she explained. "he found he could get a three days leave to come with me. of course, i wished to rush off to the farmhouse before i even got my traveling things off. but since i am a much managed woman these days, i was made to wait until you came here. i have been expecting you every minute. now tell me about nona and madame valesky." this time it was barbara who laughed. the idea of eugenia's being managed instead of managing other people was amusing. besides, it was unlike her to talk so fast and ask so many questions without giving one time to reply. so barbara only held closer to her friend's hand and looked at her, leaving mildred the opportunity for answering. it was still early in the afternoon and the sunshine flooded the beautiful drawing room. it was strange to see how at home eugenia seemed to look and feel in it, when a little more than a year before she and the old room had been so antagonistic. eugenia had changed. in the first place, she wore this afternoon a lovely costume of violet crepe, trimmed in old gold brocade. it was a costume that must have been specially designed for eugenia, so perfectly did it suit her rather stately beauty and dark, clear coloring. this turned out to be true, since eugenia a short time before had discovered a little french dressmaker, whom the war had rendered penniless, and given her work to do. now, even while mildred was talking of nona and sonya, the drawing room door opened and captain castaigne and his mother came in. monsieur le duc accompanied them, but promptly deserted his former master and mistress and padded over to eugenia, placing his great silver head on her lap and gazing at her with adoration. captain castaigne and his mother followed to greet their guests. in his hand the young officer carried a number of letters which he gave at once to barbara and mildred. "these just arrived at the chateau for you; they are american letters and so i am sure you will be pleased." mildred's were from her mother and father and barbara had received three from dick in this same mail, and another which looked as if it might be the long-expected letter from mrs. thornton. after ten minutes of conversation, it was captain castaigne who proposed that their guests might be allowed to read their letters without waiting to return home. it was not difficult to guess at their impatience, since it must have been a long time since they had heard from home. then he and eugenia crossed over to the other side of the room and stood by the fireplace. le duc went with them and eugenia kept one hand on the dog's head. now and then she smiled over something captain castaigne said to her, then again she looked at him with the anxious gravity that was a part of eugenia's character. the war had made the young french officer older, love and marriage had apparently taken ten years from eugenia's age. plainly a beautiful understanding existed between the husband and wife, in spite of the differences in their natures, which would survive to the end. for when captain castaigne suddenly lifted his wife's hand and kissed it, it was like eugenia to blush and whisper a protest, at which the young officer only laughed. over by the window barbara and mildred were really too busy with their letters to notice what was taking place. madame castaigne had gone out of the room for the instant to speak to françois. of course, barbara had read dick's letters first. she could only read them hastily, for dick had written to say that he had a fine position with a big real estate office in new york city, and enough salary for two persons to live upon, in a tiny apartment on the west side. barbara was to come home at once, else dick would probably lose his job by deserting to fetch her. also the letter from mrs. thornton was cheering. whatever it may have been, something had occurred to change that lady's state of mind. perhaps it was her anxiety about mildred in the days when she knew nothing of her daughter's fate except that mildred had stayed behind at grovno until the hour of the final surrender of the russian fort. for mrs. thornton had written to barbara to say that she would be most happy to welcome her as dick's wife, and the dearest wish of her heart was to have her two daughters safe at home in new york city as soon as they were able to return. mildred's letters were much of the same character, and the two girls had only barely finished them when françois appeared bearing coffee and cakes. then the little party talked on until nearly dusk. at last, when barbara and mildred felt compelled to leave, eugenia proposed that she and captain castaigne walk over to the farmhouse with them. she did not feel that she could wait for another day before seeing nona. nona and sonya had just been in a few moments and taken off their wraps when the others arrived. and nona need have felt no nervousness over eugenia's attitude toward sonya. many things had happened to broaden eugenia's point of view since her arrival in europe to act as a red cross nurse. besides, few persons could fail to feel anything but sympathy and admiration for the beautiful russian woman, whose life had come so near closing in tragedy. there was not a great deal of food at the farmhouse, nevertheless eugenia and captain castaigne remained to dinner. barbara and mildred retired to act as cooks, while eugenia and sonya fell to talking together, and nona and captain castaigne. in the course of their talk nona remembered to inquire for lieutenant hume, who was captain castaigne's friend. at last she might be able to hear real news of the young british officer. by good fortune captain castaigne had received a letter written by him in the same post that had brought barbara's and mildred's letters. "lieutenant hume had gone to the united states and was living at the present time in florida. he had appeared to have contracted a fatal illness during his imprisonment, but his letter had said he was feeling ever so much better. "i can't say how glad i am," captain castaigne continued. "there was never a braver fellow in the world than robert hume. and besides, if he should happen to die just now, it would be particularly hard on his family. you see, hume's older brother, the one with the title, has just been killed in the dardanelles. robert hume is lord hume now, i believe, and the english think more of titles than we do in republican france," the french officer concluded. "but i thought," nona commented stupidly, "that lieutenant hume was a gardener's son and had been educated by friends who were interested in him." then nona stopped, because captain castaigne was half smiling and half frowning over her information. moreover, nona suddenly remembered that what she was saying was founded partly on information and the rest on her own fancy. "lieutenant hume told me he was the gardener's son," she protested, "or at least he called the gardener's wife 'mother susan.'" eugenia had suddenly spoken her husband's name and captain castaigne had gotten up to go over to her. however, he stopped long enough to expostulate. "that was an extraordinary idea of yours, miss davis. hume was only talking of his old nurse. his mother died when he was a baby and she brought him up. i have heard him speak of 'mother susan' myself. the countess you visited in surrey is a cousin of hume's, i think, and the old nurse and her husband live there. hume was having mother susan nurse him when you met, i expect. hope you two may see each other some day in the united states and laugh over that impression of yours, miss davis," captain castaigne concluded, as he walked over to his wife's side. at midnight captain castaigne and eugenia went back to the chateau, walking hand-in-hand like children through the woods. there was no fighting these days in this particular portion of southern france and in the peace of the night one could almost forget that the world was at war. "you will miss your friends when they return to their own country, eugenia," captain castaigne suggested. eugenia nodded. "yes, they will be gone, i believe, in another month. but we will go over ourselves some day, henri, and perhaps you may learn to care for my country as i do for yours." "yes, and think of the service i shall owe her for the work the american red cross has done for france!" the young officer concluded, and in the darkness lifted his cap for a moment. "whatever lafayette did for you in the cause of freedom, your land has now fully repaid." the end books by margaret vandercook the ranch girls series the ranch girls at rainbow lodge the ranch girls' pot of gold the ranch girls at boarding school the ranch girls in europe the ranch girls at home again the ranch girls and their great adventure the red cross girls series the red cross girls in the british trenches the red cross girls on the french firing line the red cross girls in belgium the red cross girls with the russian army the red cross girls with the italian army the red cross girls under the stars and stripes stories about camp fire girls the camp fire girls at sunrise hill the camp fire girls amid the snows the camp fire girls in the outside world the camp fire girls across the sea the camp fire girls' careers the camp fire girls in after years the camp fire girls in the desert the camp fire girls at the end of the trail none nln press [illustration: button] nursing as caring a model for transforming practice by anne boykin and savina o. schoenhofer anne boykin, phd, rn dean and professor director, christine e. lynn center for caring college of nursing florida atlantic university boca raton, florida savina o. schoenhofer, phd professor of graduate nursing alcorn state university natchez, mississippi contents about the authors foreword preface introduction acknowledgements foundations of nursing as caring nursing as caring nursing situation as the locus of nursing implications for practice and nursing service administration implications for nursing education theory development and research epilogue index [illustration: button] about the authors anne boykin, ph.d, is dean and professor of the college of nursing at florida atlantic university in boca raton, florida. she is also director of the christine e. lynn center for caring. this center is focused on humanizing care in the community through the integration of teaching, research, and service grounded in caring. dr. boykin is past president of the international association for human caring, a member of several local boards, and is actively involved in various nursing organizations at the national, state, and local levels. she has published and consulted widely on caring in nursing. currently, she and dr. schoenhofer are engaged in a two-year funded demonstration project. the purpose of this project is to demonstrate the value of a model for health care delivery in an acute care setting that is intentionally grounded in nursing as caring. savina o. schoenhofer, ph.d, is professor of graduate nursing at alcorn state university in natchez, mississippi. dr. schoenhofer is co-founder of the nursing aesthetics publication, nightingale songs. her research and publications are in the areas of everyday caring, outcomes of caring in nursing, nursing values, nursing home management, and affectional touch. [illustration: button] foreword marilyn e. parker, phd, rn, professor of nursing florida atlantic university, boca raton, florida caring may be one of the most often used words in the english language. indeed, the word is commonly used as much in talking about our everyday lives and relationships as it is in the marketplace. at the same time, nurses thinking about, doing, and describing nursing know that caring has unique and particular meaning to them. caring is one of the first synonyms for nursing offered by nursing students and is surely the most frequent word used by the public in talking about nursing. caring is an essential value in the personal and professional lives of nurses. the formal recognition of caring in nursing as an area of study and as a necessary guide for the various avenues of nursing practice, however, is relatively new. anne boykin and savina schoenhofer have received many requests from academic peers and students to articulate the nursing theory they have been working to develop. this book is a response to the call for a theory of nursing as caring. the progression of nursing theory development often has been led by nurse theorists who stepped into other disciplines for ways to think about and study nursing and for structures and concepts to describe nursing practice. the opportunity to use language and methods of familiar, relatively established bodies of knowledge that could be communicated and widely understood took shape as many nursing scholars received graduate education in disciplines outside of nursing. conceptions and methods of knowledge development often came then from disciplines in the biological and social sciences and were brought into ways of thinking about and doing nursing scholarship. evolution of new worldviews opened the way for nurses to develop theories reflecting ideas of energy fields, wholeness, processes, and patterns. working from outside the discipline of nursing, along with shifts in worldviews, has been essential to opening the way for nurses to explore nursing as a unique practice and body of knowledge from inside the discipline, and to know nursing in unprecedented ways. nursing as caring: a model for transforming practice sets forth a different order of nursing theory. this nursing theory is personal, not abstract. in order to express nursing as caring there is a clear need to know self as caring person. the focus of the nursing as caring theory, then, is not toward an end product such as health or wellness. it is about a unique way of living caring in the world. it is about nurses and nursed living life and nurturing growing humanly through participation in life together. nursing as caring sets forth nursing as a unique way of living caring in the world. this theory provides a view that can be lived in all nursing situations and can be practiced alone or in combination with other theories. the domain of nursing is nurturing caring. the integrity, the wholeness, and the connectedness of the person simply and assuredly is central. as such, this is perhaps the most basic, bedrock, and therefore radical, of nursing theories and is essential to all that is truly nursing. the dynamic, living idea of nursing as caring must be expressed knowledgeably. perhaps for this reason, the book presents the essence of the idea and encourages its careful study and understanding in full hope for further development. in this regard, many questions come to mind in thinking about this work and its importance for the discipline and practice of nursing. * what distinguishes this nursing theory from others? * in what ways does this work add to the body of nursing knowledge? * in what new and distinct ways are we to view theories of our discipline and practice? * what are new descriptions of processes for development, study, and appraisal of nursing theories? * how will new relationships among nursing theories be discovered and described? as earlier theorists brought words and ways of other bodies of knowledge to help nurses know and articulate nursing, so some of the language of this new theory has been drawn from philosophy. generally, the language used to express the theory of nursing as caring is everyday language. this model is a clear assertion of and for nursing--it distinguishes nursing knowledge, questions, and methods from those of other disciplines. it helps us explore ways to use nursing knowledge and knowledge of other disciplines in ways appropriate to nursing. this volume offers rich illustrations of nursing that will immediately seem familiar to most nurses. many nurses will come to know new possibilities for nursing practice, teaching, administration, and inquiry more fully. in trying to open the door of this book and invite the reader to explore the nursing as caring model, i am personally aware that the living of nursing and the commitment nursing calls forth cannot be fully measured. each of us is part of the ongoing creation of nursing as we share our experience of nursing. these attempts to share our nursing are a major part of the development of nursing as a discipline and professional practice. our expressions about nursing are continually challenged as part of the creating process. the processes of theory development have been the ongoing gift of many nursing scholars, theorists, and researchers. in expressing this new theory of nursing as caring, nurses have again courageously stepped forward to develop, articulate, and publish ideas that seem very new to many, and in doing so have risked to offer opportunity for a full range of responses to this work. i know anne boykin and savina schoenhofer invite with great anticipation responses from nurses and will appreciate opportunity for dialogue. [illustration: button] preface 'the ideas which led to the development of theory of nursing as caring have their beginnings in our personal histories and came together when we met in . as we participated in the work of establishing nursing as an academic discipline and creating a nursing curriculum grounded in caring at florida atlantic university, each of us learned to value the special insights brought by the other. we also discovered early on that we shared a deep devotion to nursing--to the idea of nursing, to the practice of nursing, to the development of nursing. several years ago, we realized that our thinking had developed to the extent that we were working with more than a concept. although we are well aware of an ongoing debate in nursing over technical versus philosophical connotations of theory, we characterize our work as a general theory of nursing developed in the context of our understanding of human science. while we are familiar with the formal concept of theory used in disciplines grouped in the physical and natural sciences, we believe that mathematical form is not an appropriate model for theory work in the discipline of nursing. therefore, we do not present our work in the traditional form of concepts, definitions, statements, and propositions, but have struggled to find ways to preserve the integrity of nursing as caring through our expressions. our thinking has been particularly influenced by the work of two scholars, mayeroff and roach. both of these authors have given voice to caring in important ways--mayeroff in terms of generic caring, and roach in terms of caring person as well as caring in nursing. we are aware of other influences on our understanding of caring and caring in nursing, including paterson and zderad, watson, ray, leininger, and gaut. our conception of nursing as a discipline has been directly influenced by phenix, king and brownell, and the nursing development conference group. while this is not an exhaustive listing of the scholars who have contributed to the development of our ideas, we have made a deliberate effort to review the evolution of our thinking and to recognize significant specific contributions. chapter presents a discussion of key ideas that ground and contextualize nursing as caring. the most fundamental idea is that of person as caring with nursing conceptualized as a discipline. our understanding of this foundation has been seasoned both from within nursing and from outside the discipline, but always with the purpose of deepening our understanding of nursing. when we have gone outside the discipline to extend possibilities for understanding, we have made an effort to go beyond application, to think through the nursing relevance of ideas that seemed, on the surface, to be useful. chapter i and subsequent chapters draw on mayeroff's ( ) caring ingredients, including: * knowing--explicitly and implicitly, knowing that and knowing how, knowing directly, and knowing indirectly (p. ). * alternating rhythm--moving back and forth between a narrower and a wider framework, between action and reflection (p. ). * patience--not a passive waiting but participating with the other, giving fully of ourselves (p. ). * honesty--positive concept that implies openness, genuineness, and seeing truly (p. ). * trust--trusting the other to grow in his or her own time and own way (p. ). * humility--ready and willing to learn more about other and self and what caring involves (p, ). * hope--"an expression of the plentitude of the present, alive with a sense of a possible" (p. ). * courage--taking risks, going into the unknown, trusting (p. ). in chapter , we present the theory in its most general form. we have resisted the temptation to include examples in this chapter for two reasons: first, because an example always seemed to lead to the need to further explain and illustrate; and second, because we wished to have a general expression of the theory, undelimited by particulars, and available to facilitate further theory development. chapter elaborates on the idea of the nursing situation, and illustrates the practical meaning of the theory in a range of particular nursing situations. this chapter will probably be most satisfying to the reader whose everyday nursing discourse is that of nursing practice. some might find it useful to read this chapter first, before reading chapters and . in chapter , we explore the practice of nursing as caring and discuss nursing service administration from the perspective of the theory. chapter addresses issues and strategies for transforming nursing education and nursing education administration based on nursing as caring. our understanding of nursing as a human science discipline is the central focus of chapter . in this chapter, we discuss the necessity of transforming models of nursing inquiry to facilitate the further development of nursing knowledge in the context of the theory of nursing as caring. we also share our commitment to the ongoing development of nursing as caring and directions we wish to take in living that commitment. it has been our intention to organize and communicate the initial, comprehensive presentation of nursing as caring usefully for nurses in practice, as well as those in administrative and academic roles. we have benefited wonderfully from the dialogue resulting from formal and informal opportunities to share this work as it evolved. we look forward to continuing this dialogue. anne boykin, phd, rn dean and professor college of nursing florida atlantic university boca raton, fl savina schoenhofer, phd professor of graduate nursing alcorn state university natchez, ms reference mayeroff, m. ( ). on caring. new york: harper and row. [illustration: button] introduction the study of human caring as a unique and essential characteristic of nursing practice has gradually expanded from early definitional, philosophical, and cultural research on the meanings of caring, to the explication of theoretical definitions of caring, conceptual models, proposed taxonomy of caring concepts, a great deal of creative experimentation with research methodologies, and the development of several theories of caring. in general, one may say that knowledge of caring has grown in two ways, first by extension and, more recently, by intension. growth by extension consists of a relatively full explanation of a small region which is then carried over into an explanation of adjoining regions. growth by extension can be associated with the metaphors of building a model or putting together a jigsaw puzzle (kaplan, , p. ). in growth by intension, a partial explanation of a whole region is made more and more adequate and outlines for subsequent theory and observation are clarified. growth by intension is associated with the metaphor of gradually illuminating a darkened room. a few persons enter the room with their individual lights and are able to slowly perceive what is in that room. as more persons enter the room, it becomes more fully illuminated, and the observed reality is clarified (kaplan, , p. ). growth by extension is implicit in the early caring definitions, explications, and models. the knowledge about caring was built up piece-by-piece, in the first ten years of study, by a few nurse scholars committed to the study of human care and caring. today, some fifteen years later, progress in the study of the caring phenomenon is no longer piecemeal but gradual and on a larger scale, with illumination from the works that have preceded. growth by intension is evidenced by the development of an extant bibliography, categorization of caring conceptualizations, and the further development of human care/caring theories. although the concept of caring has not been definitively and exhaustively explored, the understanding of the broad-scale phenomena of human care and caring has become enlarged. a review of the caring literature by smerke ( ) and an analysis of the nursing research on care and caring by morse, bottoroff, leander, and solberg ( ) now provides researchers with an interdisciplinary guide to human caring literature and a categorization of five major conceptualizations of caring: ( ) a human trait, ( ) a moral imperative, ( ) an affect, ( ) an interpersonal interaction, and ( ) an intervention. there is now a body of knowledge about care and caring that can be used to further develop new knowledge through subsequent theory and research. the boykin and schoenhofer work, nursing as caring: a model for transforming practice, is an excellent example of growth by intension. utilizing previous caring research, caring theory, and personal knowledge, the authors have put forth a theory that will not only increase the content of caring knowledge but will also change its form. a new theory adds some knowledge and it transforms what was previously known, clarifying it and giving it new meaning as well as more confirmation. the whole structure of caring knowledge changes with growth, even though it is recognizably similar to what it has been. as one reads this theory, many of the assumptions presented seem familiar, perhaps because the authors realized that caring theory could best be understood in both its historical and immediate context. the historical context of the systematic study, explication, and theorizing about human care and caring phenomena in nursing began some twenty years ago with the early work of madeleine leininger. the first structural stones were laid by a group of nurse researchers who met for the first time in at a conference convened by dr. leininger at the university of utah in salt lake city. some sixteen enthusiastic participants underscored the need for continued in-depth thinking and for sharing scholarly ideas about the phenomena and nature of caring. plans were made to continue with yearly research conferences focused on four major goals: . the identification of major philosophical, epistemological, and professional dimensions of caring to advance the body of knowledge that constitutes nursing. . explication of the nature, scope, and functions of caring and its relationship to nursing care. . explication of the major components, processes, and patterns of care or caring in relationship to nursing care from a transcultural perspective. . stimulation of nurse scholars to systematically investigate care and caring and to share their findings with others. these four goals, developed by the members of the caring research conference group, provided nurse scholars with a direction for caring research that yielded a substantial piece of research-based literature. the first ten years of the conference group ( - ) witnessed a great deal of diverse and stimulating research. major philosophical dimensions of caring were explicated in the works of bevis ( ), gaut ( ), ray ( ), roach ( ), and watson ( ) explication of major components, processes, and patterns of care or caring from a transcultural perspective was first developed in the early work of aamodt ( ) and leininger ( , ), to be followed by the works of baziak-dugan ( ), boyle ( ), guthrie ( ), wang ( ), and wenger and wenger ( ). another group of nurse researchers chose to study the concept of care and caring concomitantly with nursing care practices. brown ( ), gardner and wheeler ( ), knowlden ( ), larson ( , ), riemen ( , ), sherwood ( ), and wolf ( ) investigated nurse behaviors perceived by patients and nurses as indicators of caring and noncaring in an attempt to further develop the essential structure of a caring interaction. watson, bruckhardt, brown, block, and hester ( ) proposed an alternative health care model for nursing practice and research. after seven years of implementation experience using a clinical practice model with various hospitals, wesorick ( ) presented a model that supported caring as a practice norm in hospital settings. administrative caring within an institutional or organizational culture was the research focus for nyberg ( ), ray ( , ), valentine ( , ), and wesorick ( , ). caring within educational settings and in the teacher-learner relationship also received attention by bevis ( ), bush ( ), condon ( ), and macdonald ( ). research methodologies became a focus of study as investigators struggled with how best to study nurse caring phenomena: boyle ( ), gaut ( , ), larson ( ), leininger ( ), ray ( ), riemen ( ), swanson-kauffman ( ), valentine ( ), watson ( ), and wenger ( ). by the s, it became clear that the systematic study of human care and caring as a distinct feature of the profession of nursing had evolved globally. dunlop ( ), from australia, asked: "is a science of caring possible?" bjrn ( ) described the caring sciences in denmark, and eriksson ( , ) began to develop her theories of caring as communion, and caring as health. kleppe ( ) discussed the background and development of caring research in norway. flynn ( ) compared the caring communities of nursing in england and the united states. halldorsdottir ( , ), from iceland, developed research on caring and uncaring encounters in nursing practice and in nursing education. the early endeavors of the first nurse researchers who focused on caring laid out the lines and clarified the observable realities for subsequent research and theorizing. the production of nursing theory is dependent on an intellectual apprehension of the movement between the concrete realities of nursing practice and the abstract world of those assumptions and propositions known as theories (benoliel, , p. ). the creation of new knowledge rests on some known assumptions, and boykin and schoenhofer's theory builds on the work of three other nurse scholars who have developed theories of caring in nursing, each with a differing apprehension of the realities of human care and caring: madeline leininger from an anthropological perspective--one of the first nurse theorists to focus on caring as the essence of nursing practice; sister m. simone roach, who provides a philosophical and theological perspective; and jean watson from an existential, philosophical perspective. the significance of leininger's culture-care theory ( ) is in the study of human care from a transcultural nursing perspective. this focus has led to new and unique insights about care and the nature of caring and nursing in different cultures, and has developed the knowledge so essential to providing culturally sensitive nursing care throughout the world. roach's work, the human act of caring ( , ) is recognized as one of the most substantive, insightful, and sensitive publications on human caring. her ultimate conclusion after years of study and reflection is: "caring is the human mode of being." watson, in her theory of human care ( , ), addressed the issue of nursing as a humanistic science rather than a formal or biological science. this perspective was an essential paradigm shift for nursing knowledge, but essential for study of the caring phenomena. within this context, watson developed a theory of caring in nursing that involves values, a will and a commitment to care, knowledge, caring actions, and consequences. caring then becomes a moral imperative for practitioners of the profession of nursing. boykin and schoenhofer's theory comes not only from "what is known about caring" but also from their imagination and creative sense of "what could be known." they suggest a context for personal theorizing about caring experiences, trusting that each person will examine the content of those experiences as a sequence of more or less meaningful events--meaningful both in them and in the patterns of their occurrence. the authors put forth a framework for just such reflection, and they challenge practicing nurses to "come to know self as caring person in ever deepening and broadening dimensions." if science has to do with knowing and that which is known, then theory is about knowledge production. in one sense of the term, theory activity might well be regarded as most important and distinctive for human beings because is stands for the symbolic dimension of experience (kaplan, , p. ). boykin and schoenhofer's work invites all nurses to develop nursing knowledge and to theorize from within the nursing situation. the invitation requests a sharing of both content and context of nursing experiences as they are lived in meaningful patterns that have significant bearings on all other patterns. to engage in theorizing means not only to learn by experience, but to learn from experience--that is, to take thought about what is there to be learned (kaplan, , p. ). in the thinking of alfred north whitehead ( ), theory functions not to allow prediction but to provide a frame of reference, a pattern through which one can discern particulars of any given situation. theory in this sense permits attendance or focus by giving form to otherwise unstructured content. the proposed theory, nursing as caring: a model for transforming practice, provides the context. the frame of reference through which any nurse engaged in a shared lived experience of caring can not only interpret the experience but also can perceive and symbolically express the patterns of nurse caring. the perception of patterns will give the readers and listeners a "click of meaningfulness," and the explanation will be the discovery of interconnections among patterns. the perception that everything is just where it should be to complete the pattern is what gives us intellectual satisfaction and provides the context or focus for the one aspect of reality that is the essence of nursing-caring. delores a. gaut, phd, rn immediate past president international association of human caring, inc. visiting professor university of portland school of nursing portland, oregon references aamodt, a. ( ). the care component in a health and healing system. (pp. - ). in bauwens (ed.), anthropology and health. st. louis: mosby. baziak-dugan, a. ( ). compadrazgo: a caring phenomenon among urban latinos and its relationship to health. in m. leininger (ed.), care: the essence of nursing and health (pp. - ). detroit, mi: wayne state university press. benoliel, j. ( ). the interaction between theory and research. nursing outlook, ( ), - . bevis, e. ( ). curriculum building in nursing ( nd ed.). st. louis: mosby. bevis, e. ( ). caring: a life force. in m. leininger, caring: an essential human need (pp. - ). detroit, mi: wayne state university press. bjrn, a. ( ). caring sciences in denmark. scandinavian journal of caring sciences, ( ), - . boyle, j. ( ). an application of the structural-functional method to the phenomenon of caring. in m. leininger (ed.), caring: an essential human need (pp. - ). detroit: mi: wayne state university press. boyle, j. ( ). indigenous caring practices in a guatemalan colonia. in m. leininger (ed.), care: the essence of nursing and health (pp. - ). detroit, mi: wayne state university press. brown, c. ( ). caring in nursing administration: healing through empowering. in d. gaut & m. leininger (eds.), caring: the compassionate healer (pp. - ). new york: national league for nursing. brown, l. ( ). the experiences of care: patient perspectives: topics in clinical nursing, ( ), - . bush, h. ( ). the caring teacher of nursing. in m. leininger (ed.), care: discovery and uses in clinical and community nursing (pp. - ). detroit, mi: wayne state university press. condon, e. ( ). theory derivation: application to nursing, the caring perspective within professional role development. journal of nursing education, ( ), . dunlop, m. j. ( ). is a science of caring possible? journal of advanced nursing, ( ), - . eriksson, k. ( ). vardanaets ide (the idea of caring) stockholm: almqvist & wiksell. eriksson, k. ( ). the alleviation of suffering-the idea of caring. scandinavian journal of caring sciences, ( ), - . flynn, b.c. ( ). the caring community: primary health care and nursing in england and the united states. in m. leininger (ed.), care: discovery and uses in clinical and community nursing (pp. - ). detroit, mi: wayne state university press. gardner, k., & wheeler, e. ( ). the meaning of caring in the context of nursing. in m. leininger (ed.), caring: an essential human need (pp. - ). detroit, mi: wayne state university press. gaut, d.a. ( ). development of a theoretically adequate description of caring. western journal of nursing research, ( ), - . gaut, d.a. ( ). a theoretic description of caring as action. in m. leininger (ed.), care: the essence of nursing and health (pp. - ). detroit, mi: wayne state university press. gaut, d.a. ( ). philosophical analysis as research method. in m. leininger (ed.), qualitative research methods in nursing (pp. - ). orlando, fl: grune & stratton. gaut, d.a. ( ). evaluating caring competencies in nursing practice. topics in clinical nursing, ( ), - . gustafson, w. ( ). motivational and historical aspects of care and nursing. in m. leininger (ed.), care: the essence of nursing and health (pp. - ). detroit, mi: wayne state university press. gustafson, w. ( ). motivational and historical aspects of care and nursing. in m. leininger (ed.), care: the essence of nursing and health (pp. - ). detroit, mi: wayne state university press. guthrie, b. ( ). the interrelatedness of the caring patterns in black children and caring process within black families. in m. leininger (ed.), caring: an essential human need (pp. - ). detroit, mi: wayne state university press. halldorsdottir, s. ( ). the essential structure of a caring and an uncaring encounter with a teacher: the nursing student's perspective. in m. leininger & j. watson (eds.), the caring imperative in education, new york: national league for nursing. halldorsdottir, s. ( ). five basic modes of being with another. in d. gaut & m. leininger (eds.), caring: the compassionate healer (pp. - ). new york: national league for nursing. kaplan, a. ( ). the conduct of inquiry. pa: chandler publishing. kleppe, h. ( ). background and development of caring research in norway. scandinavian journal of caring sciences, ( - ), - . knowlden, v. ( ). nurse caring as constructed knowledge. in r. neil & r. watts (eds.), caring and nursing: explorations in the feminist perspective (pp. - ), new york: national league for nursing. larson, p. ( ). important nurse caring behaviors perceived by patients with cancer. oncology nurse forum, ( ), - . larson, p. ( ). cancer nurses' perceptions of caring. cancer nursing, ( ), - . leininger, m. ( ). transcultural nursing: concepts, theories, and practices. new york: wiley. leininger, m. ( ). some philosophical, historical and taxonomic aspects of nursing and caring in american culture. in m. leininger (ed.), caring: an essential human need (pp. - ). detroit, mi: wayne state university press. leininger, m. ( ). culture care diversity and universality: a theory for nursing. new york: national league for nursing. macdonald, m. ( ). caring: the central construct for an associate degree nursing curriculum. in m. leininger (ed.), care: the essence of nursing and health (pp. ). detroit, mi: wayne state university press. morse, j., bottoroff, j., neander, w., & solberg, s. ( ). comparative analysis of conceptualizations and theories of caring. image: the journal of nursing scholarship, ( ), - . nyberg, j. ( ). the element of caring in nursing administration. nursing administration quarterly, ( ), - . ray, m. ( ). a philosophical analysis of caring within nursing. in m. leininger (ed.), caring: an essential human need (pp. - ). detroit, mi: wayne state university press. ray, m. ( ). the development of a classification system of institutional caring. in m. leininger (ed.), care: the essence of nursing and health (pp. - ). detroit, mi: wayne state university press. ray, m. ( ). the theory of bureaucratic caring for nursing practice in the organizational culture. nursing administration quarterly, ( ), - . riemen, d. ( a). noncaring and caring in the clinical setting: patients' descriptions. topics in clinical nursing, ( ), - . riemen, d. ( b). the essential structure of a caring interaction: doing phenomenology. in munhall & oiler (eds.), nursing research: a qualitative perspective (pp. ). norwalk, ct: appleton-century-crofts. roach, m.s. ( ). the human act of caring: a blueprint for the health professions. ottawa: the canadian hospital association press. roach, m.s. ( ). the human act of caring: a blueprint for the health professions rev. ed.). ottawa: the canadian hospital association press. sherwood, g. ( ). expressions of nurses' caring: the role of the compassionate healer. in d. gaut & m. leininger (eds.), caring: the compassionate healer (pp. . new york: national league for nursing. smerke, . ( ). interdisciplinary guide to the literature for human caring. new york: national league for nursing. swanson-kauffman, k. ( ). a combined qualitative methodology for nursing research. advances in nursing science, ( ), - . valentine, k. ( ). advancing care and ethics in health management: an evaluation strategy. in m. leininger (ed.), care: discovery and uses in clinical community nursing (pp. - ). detroit, mi: wayne state university press. valentine, k. ( ). caring is more than kindness: modeling its complexities. journal of nursing administration, ( ), - . valentine, k. ( ). nurse-patient caring: challenging our conventional wisdom. in d. gaut & m. leininger (eds.), caring: the compassionate healer (pp. - ). new york: national league for nursing. wang, j. ( ). caretaker-child interaction observed in two appalachian clinics. in m. leininger (ed.), care: the essence of nursing and health (pp. - ). detroit, mi: wayne state university press. watson, j. ( ). nursing: the philosophy and science of caring. boston: little, brown. watson, j. ( a). nursing: human science and human care: a theory of nursing. norwalk, ct: appleton-century-crofts. watson, j. ( b). reflections on different methodologies for the future of nursing. in m. leininger (ed.), qualitative research methods in nursing (pp. - ). orlando, fl: grune & stratton. watson, i., burckhardt, c., brown, l., bloch, d., & hester, n. ( .) a model of caring: an alternative health care model for nursing practice and research. in american nurses' association clinical and scientific sessions. kansas city: american nurses' association press. wenger, a.f. ( ). learning to do a mini-ethnonursing research study. in m. leininger (ed.), qualitative research methods in nursing (pp. - ). wenger, a.f. and wenger, m. ( ). community and family care patterns of the old order amish. in m. leininger (ed.), care: discovery and uses in clinical and community nursing (pp. - ). detroit, mi: wayne state university press. wesorick, b. ( ). standards of nursing care: a model for clinical practice. philadelphia: lippincott. wesorick, b. ( ). creating an environment in the hospital setting that supports caring via a clinical practice model. in d. gaut & m. leininger (eds.), caring: the compassionate healer. new york: national league for nursing. whitehead, a.n. ( ). science and the modern world. new york: free press. wolf, z. ( ). the caring concept and nurse identified caring behaviors. topics in clinical nursing, ( ), - . [illustration: button] acknowledgements the authors gratefully acknowledge past and present faculty and students at the college of nursing at florida atlantic university whose sharing through dialogue has contributed to the evolution of ideas over the past years. we are particularly grateful to the faculty for taking the risks necessary to advance a program of study grounded in the discipline with caring as the focal point. through supporting each other as colleagues, we were able to suspend our traditional pasts in order to study and teach the discipline with a new lens. we also are indebted to students and colleagues whose questions, stories, and expressions of nursing fostered clarity in our understanding of the ontology of nursing. a special thank you goes to the following colleagues whose stories are re-presented in this book: gayle maxwell, daniel little, sheila carr, patricia kronk, lorraine wheeler, and michele stobie. to the many scholars in the discipline whose works reflect a commitment to the development of nursing knowledge related to caring in nursing, and especially to the members of the international association of human caring, we thank you. we extend a special thanks to marilyn parker and terri touhy for their unending devotion and commitment to nursing and for the blessing of their friendship. we acknowledge shawn pennell who designed the image of the dance of caring persons described in this book. sally barhydt of the national league for nursing offered understanding and thoughtful input in the early stages of this process and we thank her for her invaluable support. thanks also to allan graubard of the league for his recognition of the meaning of our work, and for his careful attention in seeing this manuscript through to publication. we would like to recognize all persons we have been privileged to nurse. through the experience and study of these nursing situations, the knowledge of the discipline unfolds. last, we extend gratitude to our families for living caring with us and supporting our many professional endeavors. [illustration: button] chapter i -- foundations of nursing as caring in this chapter we present the fundamental ideas related to person as caring and nursing as a discipline and profession that serves as the perspectival grounding for the theory nursing as caring. we intend to offer our perspective of these ideas as influenced by the works of various scholars so that the grounding for nursing as caring will be understood. we do not intend to offer a novel perspective of the notion of person, or a new generic understanding of caring or of discipline and profession, but to communicate some of the ideas basic to nursing as caring. major assumptions underlying nursing as caring include: * persons are caring by virtue of their humanness * persons are caring, moment to moment * persons are whole or complete in the moment * personhood is a process of living grounded in caring * personhood is enhanced through participating in nurturing relationships with caring others * nursing is both a discipline and a profession perspective of persons as caring throughout this book the basic premise presides: all persons are caring. caring is an essential feature and expression of being human. the belief that all persons, by virtue of their humanness, are caring establishes the ontological and ethical ground on which this theory is built. persons as caring is a value which underlies each of the major concepts of nursing as caring and is an essential idea for understanding this theory and its implications. being a person means living caring, and it is through caring that our "being" and all possibilities are known to the fullest. elaboration on the meaning of this perspective will provide a necessary backdrop for understanding ideas in subsequent chapters. caring is a process. each person, throughout his or her life, grows in the capacity to express caring. said another way, each person grows in his or her competency to express self as caring person. because of our belief that each person is caring and grows in caring throughout life, we will not focus on behaviors considered noncaring in this book. our assumption that all persons are caring does not require that every act of a person necessarily be caring. there are many experiences of life that teach us that not every act of a person is caring. these acts are obviously not expressions of self as caring person and may well be labeled noncaring. developing the fullest potential for expressing caring is an ideal. notwithstanding the abstract context of this ideal, it is knowing the person as living caring and growing in caring that is central to our effort in this book. therefore, even though an act or acts may be interpreted as noncaring, the person remains caring. while this assumption does not require that every act be understood as an expression of caring, the assumption that all persons are caring does require an acceptance that fundamentally, potentially, and actually each person is caring. although persons are innately caring, actualization of the potential to express caring varies in the moment and develops over time. thus, caring is lived moment to moment and is constantly unfolding. the development of competency in caring occurs over a lifetime. throughout life we come to understand what it means to be a caring person, to live caring, and to nurture each other as caring. roach and mayeroff provide some explanation as to what caring involves. roach in her works ( , , ) has asserted that caring is the "human mode of being" ( , p. ix). as such, it entails the capacity to care, the calling forth of this ability in ourselves and others, responding to something or someone that matters and finally actualizing the ability to care ( , p. ). since caring is a characteristic of being human, it cannot be attributed as a manifestation of any single discipline. these beliefs have directly influenced our assumption that all persons are caring. mayeroff, a philosopher, in his book on caring, discusses caring as an end in itself, an ideal, and not merely a means to some future end. within the context of caring as process, roach ( , ) says that caring entails the human capacity to care, the calling forth of this ability in ourselves and others, the responsivity to something or someone that matters, and the actualizing of the power to care. even though our human nature is to be caring, the full expression of this varies with the lived experience of being human. the process of bringing forth this capability can be nurtured through concern and respect for person as person. mayeroff suggests that caring "is not to be confused with such meanings as wishing well, liking, comforting, and maintaining . . . it is not an isolated feeling or a momentary relationship" (p. ). he describes caring as helping the other grow. in relationships lived through caring, changes in the one who cares and the one cared for are evident. mayeroff tells us how caring provides meaning and order: in the context of a man's life, caring has a way of ordering his other values and activities around it. when this advising is comprehensive, because of the inclusiveness of his caring, there is a basic stability in his life; he is "in place" in the world instead of being out of place, or merely drifting on endlessly seeking his place. through caring for certain others, by serving them through caring a man lives the meaning of his own life. in the sense in which a man can ever be said to be at home in the world, he is at home not through dominating, or explaining, or appreciating, but through caring and being cared for ( , p. ). mayeroff expressed ideas about the meaning of being a caring person when he referred to trust as "being entrusted with the care of another" (p. ). he spoke of both "being with" the other (p. ) and "being for" (p. ) the other, experiencing the other as an extension of self and at the same time "something separate from me that i respect in its own right" (p. ). to be a caring person means to "live the meaning of my own life" (p. ), having a sense of stability and basic certainty that allows an openness and accessibility, experiencing belonging, living congruence between beliefs and behavior, and expressing a clarity of values that enables living a simplified rather than a cluttered life. watson, a nursing theorist and philosopher, offers insight into caring. in her theory of human care, she examines caring as an intersubjective human process expressing respect for the mystery of being-in-the-world, reflected in the three spheres of mind-body-soul. human care transactions based on reciprocity allow for a unique and authentic quality of presence in the world of the other. in a related vein, parse ( ) defines the ontology of caring as "risking being with someone toward a moment of joy." through being with another, connectedness occurs and moments of joy are experienced by both. if the ontological basis for being is that all persons are caring and that by our humanness caring is, then i accept that i am a caring person. this belief that all persons are caring, however, entails a commitment to know self and other as caring person. according to trigg ( ), commitment "presupposes certain beliefs and also involves a personal dedication to the actions implied by them" (p. ). mayeroff ( ) speaks of this dedication as devotion and states "devotion is essential to caring .. . when devotion breaks down, caring breaks down" (p. ). mayeroff also states that "obligations that derive from devotion are a constituent element in caring" (p. ). moral obligations arise from our commitments; therefore, when i make a commitment to caring as a way of being, i have become morally obligated. the quality of the moral commitment is a measure of being "in place" in the world. gadow ( ) asserts that caring represents the moral ideal of nursing wherein the human dignity of the patient and nurse is recognized and enhanced. as individuals we are continually in the process of developing expressions of ourselves as caring persons. the flow of life experiences provides ongoing opportunities for knowing self as caring person. as we learn to live fully each of these experiences, it becomes easier to allow self and others the space and time to develop innate caring capabilities and authentic being. the awareness of self as caring person calls to consciousness the belief that caring, is lived by each person moment to moment and directs the "oughts" of actions. when decisions are made from this perspective, the emerging question consistently is, "how ought i act as caring person?" how one is with others is influenced by the degree of authentic awareness of self as caring person. caring for self as person requires experiencing self as other and yet being one with self, valuing self as special and unique, and having the courage, humility, and trust to honestly know self. it takes courage to let go of the present so that it may be transcended and new meaning be discovered. letting go, of course, implies a freeing of oneself from present constraints so that we may see and be in new ways. one who cares is genuinely humble in being ready and willing to know more about self and others. such humility involves the realization that learning is continuous and the recognition that each experience is unique. as my commitment to persons as caring moves into the future, i must choose again and again to ratify it or not. this commitment remains binding and choices are made based on devotion to this commitment. personhood is the process of living grounded in caring. personhood implies living out who we are, demonstrating congruence between beliefs and behaviors, and living the meaning of one's life. as a process, personhood acknowledges the person as having continuous potential for further tapping the current of caring. therefore, as person we are constantly living caring and unfolding possibilities for self as caring person in each moment. personhood is being authentic, being who i am as caring person in the moment. this process is enhanced through participation in nurturing relationships with others. the nature of relationships is transformed through caring. all relations between and among persons carry with them mutual expectations. caring is living in the context of relational responsibilities. a relationship experienced through caring holds at its heart the importance of person-as-person. being in the world also mandates participating in human relationships that require re-sponsibility--responsibility to self and other. to the extent that these relationships are shaped through caring, they are consistent with the obligations entailed in relational responsibility, and the "person-al" (person-to-person) relationships. when being with self and others is approached from a desire to know person as living caring, the human potential for actualizing caring directs the moment. all relationships are opportunities to draw forth caring possibilities, opportunities to reinforce the beauty of person-as-person. through knowing self as caring person, i am able to be authentic to self and with others. i am able to see from the inside what others see from the outside. feelings, attitudes, and actions lived in the moment are matched by an inner genuine awareness. the more i am open to knowing and appreciating self and trying to understand the world of other, the greater the awareness of our interconnectedness as caring persons. knowing of self frees one to truly be with other. how does one come to know self as caring person? mayeroff's ( ) caring ingredients are useful conceptual tools when one is struggling to know self and others as caring. these ingredients include: honesty, courage, hope, knowing (both knowing about and knowing directly), trust, humility, and alternating rhythm. the idea of a hologram serves as a way of understanding self and other. pri-bram ( ) offers us an interesting view on relationships in his discussion of hologram. he states that the uniqueness of a hologram is such that if a part (of the hologram) is broken, any part of it is capable of reconstructing the total image (p. ). using this idea, if the lens for "being" in relationships is holographic, then the beauty of the person will be retained. through entering, experiencing, and appreciating the world of other, the nature of being human is ore fully understood. the notion of person as whole or complete expresses an important value. as such, the respect for the total person--all that is in the moment--is communicated. therefore, from a holographic perspective, it is impossible to focus on a part of a person without seeing the whole person reflected in the part. the wholeness (the fullness of being) is forever present. perhaps in some context, the word part is incongruent with this notion that there is only wholeness. the term aspect, or dimension, may be a useful substitute. the view of person as caring and complete is also intentional; it offers a lens for a way of being with another that prevents the segmenting of that other into component parts (e.g., mind, body, spirit). here, valuing and respecting each person's beauty, worth, and uniqueness is lived as one seeks to understand fully the meaning of values, choices, and priority systems through which values are expressed. the inherent value that persons reflect and to which they respond is the wholeness of persons. the person is at all times whole. the idea of wholeness does not negate an appreciation of the complexity of being. however, from the perspective of the theory nursing as caring, to encounter person as less than whole involves a failure to encounter person. un-il our view is such that it includes the whole as complete person and not just a part, we can not fully know the person. gadow's ( ) contrasting paradigms, empathic and philanthropic, are relevant to this understanding. the philanthropic paradigm enables a relationship in which dignity is bestowed as a "gift from one who is whole to one who is not" (p. ). philanthropy marks the person as other than one like me. gadow's empathic paradigm, on the other hand, "breaches objectivity" (p. ) and expresses participating in the experience of another. in the empathic paradigm, the subjectivity of the other is "assumed to be as whole and valid as that of the caregiver" (p. ). these paradigm descriptions facilitate our knowing how we are with others. is the attitude expressed through nursing one of person as part or person as whole? how do these perspectives direct nursing practice? our understanding of person as caring centers on valuing and celebrating human wholeness, the human person as living and growing in caring, and active personal engagement with others. this perspective of what it means to be human is the foundation for understanding nursing as a human endeavor, a person-to-person service, a human social institution, and a human science. our view enables the development of nursing as a discipline of constant discovery and new knowing. like disciplines, professions have unique characteristics, as defined by flexner. flexner ( ) initially identified as the most basic characteristic of a profession that it addresses a unique and urgent social need through techniques derived from a tested knowledge base. professions have their historical roots in those human services that people provided for each other within existing social institutions (e.g., tribe, family, or community). thus, each profession, including nursing, has its origins in everyday human situations and the everyday contributions people make to the welfare of others. flexner's founding conditions for the designation profession are reiterated in the american nursing association's social policy statement, in which the idea of a social contract is addressed. nursing: a social policy statement was intended to provide nurses with a fresh perspective on practice while providing society with a view of nursing for the s. the overall intent of this document was to call to consciousness the linkages between the profession and society. while the social policy statement is considered by many (see, for example, rodgers, ; packard & polifroni, ; allen, ; white, ) to be outdated, we find the concept of the social contract to be useful when studying the relationship of nurse to nursed. as the foundation for professions, the social contract, while understood to be an "hypothetical ideal" (silva, , p. ), is also an expression of a people recognizing ( ) the presence of a basic need and ( ) the existence of greater knowledge and skill available to meet that need than can be readily exercised by each member of the society. society at large then calls for commitment by a segment of society to the acquisition and use of this knowledge and skill for the good of all. social goods are promised in return for this commitment. today, the profession of nursing is moving from a social contract relationship toward a covenantal relationship between the nurse and nursed. while the social contract implies an impersonal, legalistic stance, the covenantal relationship emphasizes personal engagement and ever present freedom to choose commitments. cooper ( ), for example, discusses her ideas on the relevance of covenantal relationships for nursing ethics. she states "the promissory nature of the covenant is contained in the willingness of individuals to enter a covenental relationship" (p. ) and it is within this context that obligations arise. as caring persons, we "see" relationship (covenant) and honor the bond between self and other. the ultimate knowledge gained from this perspective is that we are related to one another (and to the universe) and that harmony (brotherhood and sisterhood) is present as we live out caring relationships. concepts of discipline and profession have been dismissed by critical theorists as oppressive, anachronistic, and paternalistic (allen, ; rodgers, ). in our study however, as we have explored essential meanings of these concepts, we have found that they express fundamental values congruent with cherished nursing values. although we can agree with critical theorists that discipline and profession have been misused, perhaps too frequently, as tools of social elitism and oppression, this misuse remains inappropriate because it violates the covenantal nature of discipline and profession. the discipline of nursing attends to the discovery, creation, structuring, testing, and refinement of knowledge needed for the practice of nursing. concomitantly, the profession of nursing attends to the use of that knowledge in response to specific human needs. certainly, the basic values communicated in the concepts of discipline and profession are resonate with fundamental nursing values and contribute to a fuller understanding of nursing as caring. included among those shared values are commitment to something that matters, sense of persons being connected in oneness; expression of human imagination and creativity, realization of the unity of knowing with possibilities unfolding, and expression of choice and responsibility. we have deliberately used the term general theory of nursing to characterize our work. the concept of a general theory is particularly useful in the context of levels of theory. other authors have addressed what they see as three levels of nursing theory: general or grand, mid-range, and practice (walker & avant, ; fawcett, ; chinn & jacobs, : nursing development conference group, ). what we intend by the use of the term general theory is similar to "conceptual framework," "conceptual model," or "paradigm." that is, a general theory is a framework for understanding any and all instances of nursing, and may be used to describe or to project any given situation of nursing. it is a system of values ordered specifically to reflect a philosophy of nursing to guide knowledge generation and to inform practice. the statement of focus of any general nursing theory offers an explicit expression of the social need that calls for and justifies the professional service of nursing. in addition, the statement of focus expresses the domain of a discipline as well as the intent of the profession, and thus directs the development of the requisite nursing knowledge. activity to develop and use nursing knowledge has its ethical ground in the idea of the covenantal relationship as expressed in the specific focus of the profession. fundamental values inherent in the discipline and profession of nursing derive from an understanding of the focus of nursing. the conception of nursing that we have used in this book views nursing science as a form of human science. nursing as caring focuses on the knowledge needed to understand the fullness of what it means to be human and on the methods to verify this knowledge. for this reason, we have not accepted the traditional notion of theory which relies on the "received" view of science, and depends on measurement as the ultimate tool for legitimate knowledge development. the human science of nursing requires the use of all ways of knowing. carper's ( ) fundamental patterns of knowing in nursing are useful conceptual tools for expanding our view of nursing science as human science here. these patterns provide an organizing framework for asking epistemological questions of caring in nursing. to experience knowing the whole of a nursing situation with caring as the central focus, each of these patterns comes into play. personal knowing focuses on knowing and encountering self and other intuitively, the empirical pathway addresses the sense, ethical knowing focuses on moral knowing of what "ought to be" in nursing situations, and aesthetic knowing involves the appreciating and creating that integrates all patterns of knowing in relation to a particular situation. through the richness of the knowledge gleaned, the nurse as artist creates the caring moment (boykin & schoenhofer, ). nursing, as we have come to understand our discipline, is not a normative science that stands outside a situation to evaluate current observations against empirically derived and tested normative standards. nursing as a human science takes its value from the knowledge created within the shared lived experience of the unique nursing situation. although empirical facts and norms do play a role in nursing knowledge, we must remember that that role is not one of unmediated application. knowledge of nursing comes from within the situation. the nurse reaches out into a body of normative information, transforming that information as understanding is created from within the situation. the same can be said for personal and ethical knowing. each serves as a pathway for transforming knowledge in the creation of aesthetic knowing within the nursing situation. the view we have taken unifies previously dichotomized notions of nursing as science and nursing as art and requires a new understanding of science. nursing as caring reflects an appreciation of persons in the fullness of per-sonhood within the context of the nursing situation. this view transcends perspectives adopted in an earlier period of nursing science philosophy. examples of the earlier view include the notions of basic versus applied science, and metaphysics versus theory. the idea of a basic science of nursing disconnects nursing from its very ground of ethical value. without a grounding in praxis, the content and activity of nursing science becomes amoral and meaningless. similarly, this view transcends an earlier view of nursing theory that treated the unitary phenomenon of nursing as being composed of concepts that could be studied independently or as "independent and dependent variables." nursing as caring resists fragmentation of the unitary phenomenon of our discipline. in subsequent chapters, we will more fully explore implications of this view of nursing as a human science discipline and profession. references allen, d.g. ( ). nursing research and social control: alternative models of science that emphasize understanding and emancipation. image, ( ), - . allen, d.g. ( ). the social policy statement; a reappraisal. advances in nursing science, (i), - . american nurses association. ( ). nursing: a social policy statement. kansas city: american nurses association. ykin, a., & schoenhofer, s. ( ). caring in nursing: analysis of extant theory. nursing science quarterly, , - . carper, b. ( ). fundamental patterns of knowing in nursing. advances in nursing science, , - . chinn, p, & jacobs, m. ( ). theory and nursing. st. louis: mosby. cooper, m.c. ( ). covenantal relationships: grounding for the nursing ethic. advances in nursing science, ( ), - . fawcett, t. ( ). analysis and evaluation of conceptual models of nursing. philadelphia: f.a. davis. flexner, a. ( ). medical education in the united states and canada. new york: carnegie foundation. gadow, s. ( ). existential advocacy: philosophical foundations of nursing. in s. spicker & gadow, s., (eds.), nursing: images and ideals. new york: springer, pp. - . gadow, s. ( ). touch and technology: two paradigms of patient care. journal of reli- gion and health, , - . king, a., & brownell j. ( ). the curriculum and the disciplines of knowledge. huntington. ny: robert e. krieger publishing co. mayeroff, m. ( ). on caring. new york: harper & row. nursing development conference group. ( ). concept formalization in nursing: process and product. boston: little, brown. packard, s.a., & polifroni, e.c. ( ). the dilemma of nursing science: current quandaries and lack of direction. nursing science quarterly, ( ), - . parse, r. ( ). caring from a human science perspective. in m. leininger (ed.). car- ing: an essential human need. thorofare, nj: slack. (reissued by wayne state uni- versity press, detroit, ). phenix, p. ( ). realms of meaning. new york: mcgraw hill. pribram, k,h. ( ). languages of the brain: experimental paradoxes and principles in neuro- psychology. englewood cliffs, nj: prentice-hall. roach, s. ( ). caring: the human mode of being, implications for nursing. toronto: faculty of nursing, university of toronto. roach, s. ( ). the human act of caring. ottawa: canadian hospital association. roach, s. ( revised). the human act of caring. ottawa: canadian hospital association. rodgers, b.l. ( ). deconstructing the dogma in nursing knowledge and practice. image, ( ), - . silva, m.c. ( ). the american nurses' association position statement on nursing and social policy: philosophical and ethical dimensions. journal of advanced nursing, ( ), - . tillich, p. ( ). the courage to be. new haven: yale university press. trigg, r. ( ). reason and commitment. london: cambridge university press. walker, l., & avant, k. ( ). strategies for theory construction in nursing. norwalk, ct: appleton & lange. watson, j. ( ; ). nursing: human science and human care, a theory of nursing. nor- walk, ct: appleton-century-crofts. white, c.m. ( ). a critique of the ana social policy statement ... population and environment focused nursing. nursing outlook, ( ), - . [illustration: button] chapter ii. -- nursing as caring in chapter , we will present the general theory of nursing as caring. here, the unique focus of nursing is posited as nurturing persons living caring and growing in caring. while we will discuss the meaning of that statement of focus in general terms, we will also describe specific concepts inherent in this focus in the context of the general theory. if you recall, in chapter we discussed the several major assumptions that ground the theory of nursing as caring: * persons are caring by virtue of their humanness * persons are whole or complete in the moment * persons live caring, moment to moment * personhood is a process of living grounded in caring * personhood is enhanced through participating in nurturing relationships with caring others * nursing is both a discipline and profession in this and succeeding chapters, we will develop the nursing implications of these assumptions. all persons are caring. this is the fundamental view that grounds the focus of nursing as a discipline and a profession. the unique perspective offered by the theory of nursing as caring builds on that view by recognizing personhood as a process of living grounded in caring. this is meant to imply that the fullness of being human is expressed as one lives caring uniquely day to day. the process of living grounded in caring is enhanced through participation in nurturing relationships with caring others, particularly in nursing relationships. within the theoretical perspective given herein, a further major assumption appears: persons are viewed as already complete and continuously growing in completeness, fully caring and unfolding caring possibilities moment-to-moment. such a view assumes that caring is being lived by each of us, moment to moment. expressions of self as caring person are complete in the moment as caring possibilities unfold; thus, notwithstanding other life contingencies, one continues to grow in caring competency, in fully expressing self as caring person. to say that one is fully caring in the moment also involves a recognition of the uniqueness of person with each moment presenting new possibilities to know self as caring person. the notion of "in the moment" reflects the idea that competency in knowing self as caring and as living caring grows throughout life. being complete in the moment also signifies something more: there is no insufficiency, no brokenness, or absence of something. as a result, nursing activities are not directed toward healing in the sense of making whole; from our perspective, wholeness is present and unfolding. there is no lack, failure, or inadequacy which is to be corrected through nursing--persons are whole, complete, and caring. the theory of nursing as caring, then, is based on an understanding that the focus of nursing, both as a discipline and as a profession, involves the nurturing of persons living caring and growing in caring. in this statement of focus, we recognize the unique human need to which nursing is the response as a desire to be recognized as caring person and to be supported in caring. this focus also requires that the nurse know the person seeking nursing as caring person and that the nursing action be directed toward nurturing the nursed in their living caring and growing in caring. we will briefly discuss this theory in general terms here and more fully illuminate it in subsequent chapters on nursing practice (chapter ), education (chapter ), and scholarship (chapter ). we will address administration of nursing services and of nursing education programs in chapters and , respectively. nurturing persons living caring and growing in caring at first glance appears broad and abstract. in some ways, the focus is broad in that it applies to nursing situations in a wide variety of practical settings. on the other hand, it takes on specific and practical meaning in the context of individual nursing situations as the nurse attempts to know the nursed as caring person and focuses on nurturing that person as he or she lives and grows in caring. when approaching a situation from this perspective, we understand each person as fundamentally caring, living caring in his or her everyday life. forms of expressing one's unique ways of living caring are limited only by the imagination. recognizing unique personal ways of living caring also requires an ethical commitment and knowledge of caring. in our everyday lives, failures to express caring are readily recognized. the ability to articulate instances of noncaring does not seem to take any particular skill. when nursing is called for, however, it is necessary that nurses have the commitment, knowledge, and skill to discover the individual unique caring person to be nursed. for example, the nurse may encounter one who may be described as despairing. relating to that person as helpless recalls gadow's ( ) characterization of the philanthropic paradigm which assumes "sufficiency and independence on one side and needy dependence on the other" (p. ). the relationship grounded in nursing as caring would enable the nurse to connect with the hope that underlies an expression of despair or hopelessness. personal expressions such as despair, or fear, or anger, for example, are neither ignored nor discounted. rather, they are understood as the caring value which is in some way present. an honest expression of fear or anger, for example, is also an expression of vulnerability, which expresses courage and humility. we reiterate that our approach is grounded in the fundamental assumption that all persons are caring and the commitment which arises from this basic value position. it is this understanding of person as caring that directs professional nursing decision making and action from the point of view of our nursing as caring theory. the nurse enters into the world of the other person with the intention of knowing the other as caring person. it is in knowing the other in their "living caring and growing in caring" that calls for nursing are heard. of equal importance is our coming to know how the other is living caring in the situation and expressing aspirations for growing in caring. the call for nursing is a call for acknowledgement and affirmation of the person living caring in specific ways in this immediate situation. the call for nursing says "know me as caring person now and affirm me." the call for nursing evokes specific caring responses to sustain and enhance the other as they live caring and grow in caring in the situation of concern. this caring nurturance is what we call the nursing response. nursing situation the nursing situation is a key concept in the theory of nursing as caring. thus, we understand nursing situation as a shared lived experience in which the caring between nurse and nursed enhances personhood. the nursing situation is the locus of all that is known and done in nursing. it is in this context that nursing lives. the content and structure of nursing knowledge are known through the study of the nursing situation. the content of nursing knowledge is generated, developed, conserved, and known through the lived experience of the nursing situation. nursing situation as a construct is constituted in the mind of the nurse when the nurse conceptualizes or prepares to conceptualize a call for nursing. in other words, when a nurse engages in any situation from a nursing focus, a nursing situation is constituted. in the scandinavian countries, for instance, all the helping disciplines are called caring sciences. professions such as medicine, social work, clinical psychology, and pastoral counseling have a caring function; however, caring per se is not their focus. rather, the focus of each of these professions addresses particular forms of caring or caring in particular ranges of life situations. in nursing situations, the nurse focuses on nurturing person as they live and grow in caring. while caring is not unique to nursing, it is uniquely expressed in nursing. the uniqueness of caring in nursing lies in the intention expressed by the statement of focus. as an expression of nursing, caring is the intentional and authentic presence of the nurse with another who is recognized as person living caring and growing in caring. here, the nurse endeavors to come to know the other as caring person and seeks to understand how that person might be supported, sustained, and strengthened in kis or her unique process of living caring and growing in caring. again, each person in interaction in the nursing situation is known as caring. each person grows in caring through interconnectedness with other. calls for nursing are calls for nurturance through personal expressions of caring, and originate within persons who are living caring in their lives and hold dreams and aspirations of growing in caring. again, the nurse responds to the call of the caring person, not to some determination of an absence of caring. the contributions of each person in the nursing situation are also directed toward a common purpose, the nurturance of the person in living and growing in caring. in responding to the nursing call, the nurse brings an expert (expert in the sense of deliberately developed) knowledge of what it means to be human, to be caring, as a fully developed commitment to recognizing and nurturing caring in all situations. the nurse enters the other's world in order to know the person as caring. the nurse comes to know how caring is being lived in the moment, discovering unfolding possibilities for growing in caring. this knowing clarifies the nurse's understanding of the call and guides the nursing response. in this context, the general knowledge the nurse brings to the situation is transformed through an understanding of the uniqueness of that particular situation. every nursing situation is a lived experience involving at least two unique persons. therefore, each nursing situation differs from any other. the reciprocal nature of the lived experience of the nursing situation requires a personal investment of both caring persons. the initial focus is on knowing persons as caring, both nurse and nursed. the process for knowing self and other as caring involves a constant and mutual unfolding. in order to know the other, the nurse must be willing to risk entering the other's world. for his or her part, other person must be willing to allow the nurse to enter his or her world this to happen, the acceptance of trust and strength of courage needed, person in the nursing situation can be awe-inspiring. it is through the openness and willingness in the nursing situation that presence with other occurs. presence develops as the nurse is willing to risk entering the world of the other and as the other invites the nurse into a special, intimate space. the encountering of the nurse and the nursed gives rise to a phenomenon we call caring between, within which personhood is nurtured. the nurse as caring person is fully present and gives the other time and space to grow. through presence and intentionality, the nurse is able to know the other in his or her living and growing in caring. this personal knowing enables the nurse to respond to the unique call for nurturing personhood. of course, responses to nursing calls are as varied as the calls themselves. all truly nursing responses are expressions of caring and are directed toward nurturing persons as they live and grow in the caring in the situation. in the situation, the nurse draws on personal, empirical, and ethical knowing to bring to life the artistry of nursing. when the nurse, as artist, creates a unique approach to care based on the dreams and goals of the one cared for, the moment comes alive with possibilities. through the aesthetic, the nurse is free to know and express the beauty of the caring moment (boykin & schoenhofer, ). this full engagement within the nursing situation allows the nurse to truly experience nursing as caring, and to share that experience with the one nursed. in chapter , we noted that each profession arose from some everyday service given by one person or another. nursing has long been associated with the idea of mothering, when mothering is understood as nurturing the personhood of another. the ideal mother (and father) recognizes the child as caring person, perfect in the moment and unfolding possibilities for becoming. the parent acknowledges and affirms the child as caring person and provides the caring environment that nurtures the child in living and growing in caring. the origins of nursing may well be found in the intimacy of parental caring. the roles of both parent and nurse permit and at times even expect that one be involved in the intimacy of the daily life of another. the parent is present in all situations to care for the child. ideally, parents know the child as eminently worthwhile and caring, despite all the limitations and human frailties. as we recognized in chapter , professions arise from the special needs of everyday situations, and nursing has perhaps emerged in relation to a type of caring that is synonymous with parenthood and friendship. the professional nurse, schooled in the discipline of nursing, brings expert knowledge of human caring to the nursing situation. in the early years of nursing model development, nursing scholars endeavored to articulate their discipline using the perspective of another discipline, for example, medicine, sociology, or psychology. one example of this endeavor is the roy adaptation model, in which scientific assumptions reflect von bertalanffy's general systems theory and helson's adaptation level theory (roy and andrews, , p. ). parson's theory of social system analysis is reflected in johnson's behavioral system model for nursing and orem's self-care deficit theory of nursing (meleis, ). a second trend involved declaring that the uniqueness of nursing was in the way in which it integrated and applied concepts from other disciplines. the emphasis in the s on nursing model development came as an effort to articulate and structure the substance of nursing knowledge. this work was needed to enhance nursing education, previously based on rules of practice, and to provide a foundation for an emerging interest in nursing research. nursing scholars engaged in model development as an expression of their commitment to the advancement of nursing as a discipline and profession, and we applaud their contributions. it is our view, however, that these early models, grounded in other disciplines, do not directly address the essence of nursing. the development of nursing as caring has benefited from these earlier efforts as well as from the work of more recent scholarship that posits caring as the central construct and essence (leininger, ), and the moral ideal of nursing (watson, ). the perspective of nursing presented here is notably different from most conceptual models and general theories in the field. the most radical difference becomes apparent in the form of the call for nursing. most extant nursing theories, modeled after medicine and other professional fields, present the formal occasion for nursing as problem, need, or deficit (e.g., self-care) deficit theory [orem, ], adaptation nursing [roy and andrews, ], behavioral system model [johnson, ], and [neuman, .] such theories then explain how nursing acts to right the wrong, meet the need, or eliminate or ameliorate the deficit. the theory of nursing as caring proceeds from a frame of reference based on interconnectedness and collegiality rather than on esoteric knowledge, technical expertise, and disempowering hierarchies. in contrast, our emerging theory of nursing is based on an egalitarian model of helping that bears witness to and celebrates the human person in the fullness of his or her being, rather than on some less-than-whole condition of being. references boykin, a., & schoenhofer, s. ( ). story as link between nursing practice, ontology, epistemology. image, , - . gadow, s. ( ). touch and technology: two paradigms of patient care. journal of religion and health, , - . johnson, d.e. ( ). the behavioral system model of nursing. in j. riehl & c. roy (eds.), conceptual models for nursing practice ( nd ed.). new york: appleton-century-crofts. leininger, m.m. ( ). leininger's theory of nursing: cultural care diversity and universality. nursing science quarterly, , - . meleis, a. ( ). theoretical nursing: development & progress. philadelphia: j.b. lippencott. neuman, b. ( ). the neumans systems model. norwalk, ct: appleton & lange. orem, d.e. ( ). nursing: concepts of practice ( rd ed.). new york: mcgraw hill. roy, c., & andrews, h. ( ). the roy adaptation model: the definitive statement. norwalk, ct: appleton & lange. watson, j. ( ). nursing: human science and human care. a theory of nursing. norwalk, ct: appleton-century-crofts. [illustration: button] chapter iii -- nursing situation as the locus of nursing the concept of nursing situation is central to every aspect of the theory of nursing as caring. we have claimed that all nursing knowledge resides within the nursing situation (boykin & schoenhofer, ). the nursing situation is both the repository of nursing knowledge and the context for knowing nursing. the nursing situation is known as shared lived experience in which the caring between the nurse and the one nursed enhances personhood. it is to the nursing situation that the nurse brings self as caring person. it is within the nursing situation that the nurse comes to know the other as caring person, expressing unique ways of living and growing in caring. and it is in the nursing situation that the nurse attends to calls for caring, creating caring responses that nurture personhood. it is within the nursing situation that the nurse comes to know nursing, in the fullness of aesthetic knowing. the nursing situation comes into being when the nurse actualizes a personal and professional commitment to the belief that all persons are caring. it should be recognized that a nurse can engage in many activities in an occupational role that are not necessarily expressions of nursing. when a nurse practices nursing thoughtfully, that nurse is guided by his or her conception of nursing. the concept of nursing formalized in the nursing as caring theory is at the very heart of nursing, extending back into the unrecorded beginnings of nursing and forward into the future. acknowledgement of caring as the core of nursing implies that any nurse practicing nursing thoughtfully is creating and living nursing situations because, whether explicit or tacit, the caring intent of nursing is present. remember that the nursing situation is a construct held by the nurse, any interpersonal experience contains the potential to become a nursing situation. in the formal sense of professional nursing, the nursing situation develops when one person presents self in the role of offering the professional service of nursing and the other presents self in the role of seeking, wanting, or accepting nursing service. the nurse intentionally enters the situation for the purpose of coming to know the other as caring person. the nurse is also allowing self to be known as caring person. authentic presence, like most human capacities, is inherent and can be more fully developed through intention and deliberate effort. authentic presence may be understood simply as one's intentionally being there with another in the fullness of one's personhood. caring communicated through authentic presence is the initiating and sustaining medium of nursing within the nursing situation. the nurse, with developed authentic presence and open to knowing the other as caring, begins to understand the other's call for nursing. a call for nursing is a call for specific forms of caring that acknowledge, affirm, and sustain the other as they strive to live caring uniquely. we must remember as well that calls for nursing originate within the unique relationship of the nursing situation. as the situation ensues, the call for nursing clarifies. the nurse comes to know the one nursed more and more deeply and to understand more fully the unique meaning of the person's caring ways and aspirations for growing in caring. it is in this understanding that the call for nursing is known as a specific situated expression of caring and a call for explicit caring response. the nursing response of caring is also uniquely lived within each nursing situation. in the nursing situation, the call of the nursed is a personal "reaching out" to a hoped-for other. the nursed calls forth the nurse's personal caring response. while the range and scope of human caring expression can and must be studied, the caring response called forth in each nursing situation is created for that moment. the nurse responds to each call for nursing in a way that uniquely represents the fullness (wholeness) of the nurse. how i might respond to such a call would and should reflect my unique living of caring as person and nurse. each response to a particular nursing situation would be slightly different and would portray the beauty of the nurse as person. the nursing situation is a shared lived experience. the nurse joins in the life process of the person nursed and brings his or her life process to the relationship as well. in the nursing situation, there is caring between the participants. further, the experience of the caring within the nursing situation enhances personhood, the process of living grounded in caring. each of these components of the construct of the nursing situation raises questions for immediate and continuing discussion. how can an unconscious patient be a participant in a nursing situation? can "postmortem care" be considered nursing? how can the nurse know that the other is truly open to nursing--can the nurse impose self into the world of the other? what about an unrepentant child rapist or a person responsible for genocide, can we say that person is caring, and if not, can we nurse them? does the nurse have to like the person being nursed? does the nurse seek enhancement of personhood in the nursing situation? if so, might the goals of the nurse be imposed on the one nursed? if the nurse gains from the nursing situation, isn't that unprofessional? in part, these legitimate questions raise larger issues about the uniqueness and scope of nursing as a discipline and professional service in society. certainly the study of these questions adds clarity to the purpose of nursing actions. to nurse, situations in a general sense are transcended and transformed when they are conceptualized as nursing situations. from the perspective of the nursing as caring theory, the study of these questions would require that the nurse transcend social or other situational contexts and live out a commitment to nurture the person in the nursing situation as they live and grow in caring. persons with altered levels of consciousness, measured on normative scales developed for medical science purposes, can and do participate in nursing situations. nurses committed to knowing the unconscious as caring person can and do describe their ways of expressing caring and aspirations for growing in caring. nurses speak of the post-anesthesia patient as living hope in their struggle to emerge from the deadening effects of the anesthesia; as living honestly in fretful, fearful thrashing. nurses help these persons sustain hope and extend honesty through their care. the profoundly mentally disabled child lives humility moment-to-moment and calls forth caring responses to validate and nurture that beautiful humility. nurses speak of caring for their deceased patients as nursing those who have gone and are still in some way present. the nurse, connected in oneness with the one known and nursed, holds hope for the other as the other's expression of hopefulness lives on in the consciousness of the nurse. thus, a sense of connectedness does not dissipate when physical presence ends, but remains an active part of the nurse's experience. nursing another is a service of caring, communicated through authentic presence. nursing another means living out a commitment to knowing the other as caring person and responding to the caring other as someone of value (boykin & schoenhofer, , ). in its fullest sense, nursing cannot be rendered impersonally, but must be offered in a spirit of being connected in oneness. "to care for" seems to require that the caregiver see oneself as caring person reflected in the other (watson, ). the theoretical perspective of nursing as caring is grounded in the belief that caring is the human mode of being (roach, ). when a person is judged by social standards to be deviant and even evil, however, it is difficult to summon caring. this points to the contribution nursing is called upon to make in society. when we speak of nursing's contribution here, we are invoking earlier discussions of discipline and profession. each discipline and profession illuminates a special aspect of person--in effect, what it means to be human. the light that nursing shines on the world of person is knowledge of person as caring, so that the particular contribution of nursing is to illuminate the person as caring, living caring uniquely in situation and growing in caring. in nursing, practiced within the context of nursing as caring, the person is taken at face value as caring and never needs to prove him or herself as caring. the nurse, practicing within the context of nursing as caring, is skilled at recognizing and affirming caring in self and others. being caring, that is, living one's commitment to this value "important-in-self" (roach, ), fuels the nurse's growing in caring and enables the nurse i turn to nurture others in their living and growing in caring. the values and assumptions of nursing as caring can assist the nurse to engage fully in nursing situations with persons in whom caring is difficult to discover. nursing knowledge is discovered and tested in the ongoing nursing situations. once experienced, nursing situations can be made available for living anew, with new discovery and testing. aesthetic representation of nursing situations brings the lived experience into the realm of new experience. thus, the knowledge of nursing can be made available for further study. re-presentation of nursing situations can occur through the medium of nursing stories, poetry, painting, sculpture, and other art forms (schoenhofer, ). aesthetic re-presentation conserves the epistemic integrity of nursing while permitting full appreciation of the singularity of any one nursing situation (boykin & schoenhofer, ). here, then, is one nurse's story of a shared lived experience in which the caring between nurse and the one nursed enhanced personhood. this story is offered as an example of nursing situation, re-presented as an open text, available for continuing participation by all who wish to enter into this shared lived experience of nursing. in fact, we invite the reader to enter into this nursing situation, which may then be used in classroom or conference settings to stimulate general or specific inquiry and dialogue. connections one night as i listened to the change of shift report, i remember the strange feeling in the pit of my stomach when the evening nurse reviewed the lab tests on tracy p tall, strawberry-blonde and freckle-faced, tracy was struggling with the everyday problems of adolescence and fighting a losing battle against leukemia. tracy rarely had visitors. as i talked with tracy this night i felt resentment from her toward her mother, and i experienced a sense of urgency that her mother be with her. with tracy's permission i called her mother and told her that tracy needed her that night. i learned that she was a single mother with two other small children, and that she lived several hours from the hospital. when she arrived at the hospital, distance and silence prevailed. with encouragement, the mother sat close to tracy and i sat on the other side, stroking tracy's arm. i left the room to make rounds and upon return found mrs. p. still sitting on the edge of the bed fighting to stay awake. i gently asked tracy if we could lie on the bed with her. she nodded. the three of us lay there for a period of time and i then left the room. later, when i returned, i found tracy wrapped in her mothers arms. her mothers eyes met mine as she whispered "she's gone." and then, "please don't take her yet." i left the room and closed the door quietly behind me. it was just after o'clock when i slipped back into the room just as the early morning light was coming through the window. "mrs. p," i reached out and touched her arm. she raised her tear-streaked face to look at me. "it's time," i said and waited. when she was ready, i helped her off the bed and held her in my arms for a few moments. we cried together. "thank you, nurse," she said as she looked into my eyes and pressed my hand between hers. then she turned and walked away. the tears continued down my cheeks as i followed her to the door and watched her disappear down the hall. gayle maxwell ( ) this nursing situation is replete with possibilities for nurses, and others, to understand nursing as nurturing persons living caring and growing in caring. a dialogue ensues on the nursing situation that allows participants an opportunity to experience both resonance and uniqueness as personal and shared understandings emerge. as the reader enters into the text, the nursing situation is experienced anew, now within the presence of two nurses, not one. though intentionally entering the situation, the second nurse experiences d affirms being connected in oneness with both nurse and nursed as caring lived in the moment. gayle entered into tracy's world that night open to hearing a special call. gayle's openness was partly a reflection of her use of the empirical pathway of knowing, the data given in report, the comparison of empirical observations against biological, psychological, developmental, and social norms. before discussing our understanding of gayle's response from the theoretical per-perspective represented, it might be helpful to compare how the call for nursing may have been interpreted if approached, for example, from a psychological framework. if the nurse responded from a psychological framework, the problem identified would perhaps be conceptualized as denial on the part of tracy's mother. it could be assumed that tracy's mother was avoiding the reality of the impending death of her daughter. here, the nursing goal would be assist the mother in dealing with her denial by facilitating grieving. denial is only one psychological concept that could be applied in this situation; avoidance, anxiety, and loss are others. when nursing care is based on a psychological framework, however, the central theme of care is likely to be deemphasized in favor of a problem-oriented approach. the perspective offered by a normative discipline requires a reliance on empirical knowing. using only the empirical pathway of knowing, the richness of nursing is lost. gayle's personal knowing, her intuition, however, was the pathway that illuminated the appreciation of this situation and prompted her acknowledgement of a call. she heard tracy's call for intimacy, comfort, and protection of her mother's presence as she (tracy) summoned courage and hope for her journey. gayle intuitively knew that the specific caring being called forth was the caring of a mother. gayle's caring response also took the form of the courageous acknowledgement of a call for nursing that would be difficult to sub-stantiate empirically. beyond telephoning tracy's mother, gayle continued her nursing effort to answer tracy's call for the presence of a mother as she supported mrs. p. living her interconnectedness, in being with tracy. gayle heard mrs. p.'s calls for knowing, knowing what to do and knowing that it would be right to do it, for the courage to be with her daughter in this new difficult passage. her response of showing the way reflects hope and humility. the caring between the nurse and the ones nursed enhanced the personhood of all three, as each grew in caring ways. it is possible that the caring between the original participants in the nursing situation and those of us who are participating through engagement with the text continues to enhance personhood. references boykin, a., & schoenhofer, s. ( ). story as link between nursing practice, ontology, epistemology. image, , - . boykin, a., & schoenhofer, s. ( ). caring in nursing: analysis of extant theory. nursing science quarterly, , - . maxwell, g. ( ). connections. nightingale songs, ( ). p.o. box , west palm beach, fl . paterson, j., & zderad, l. ( ). humanistic nursing. new york: national league for nursing press. roach, s. ( ). caring: the human mode of being, implications for nursing. toronto: faculty of nursing, university of toronto. (perspectives in caring monograph ). schoenhofer, s. ( ). love, beauty and truth: fundamental nursing values. journal of nursing education, ( ), - . watson, j. ( ). nursing on the caring edge; metaphorical vignettes. advances in nursing science, , - . [illustration: button] chapter iv. -- implications for practice and nursing service administration foundations for practice of the nursing as caring theory rest on the nurse coming to know self as caring person in ever deepening and broadening dimensions. while all nurses may have (or at least, may have had) a sense of self as caring person, practicing within this theoretical framework requires a deliberate commitment to developing this knowledge. in many settings where nurses find themselves practicing, there is little in the environment to support a commitment to ongoing development of a sense of self as caring person. in fact, many practice environments seem to support knowing self only as instrument, self as technology. when one perceives of one's "nursing self" as a depersonalized, disembodied tool, nursing tends to lose its flavor and the devoted commitment to nursing burns out. so how to sustain and actualize this fundamental commitment must be a point of serious study for the nurse who desires to practice nursing as caring. mayeroff's ( ) caring ingredients are useful tools to assist the nurse in developing an ever-present awareness of self as caring person. taking note of personal patterns of expressing hope, honesty, courage, and the other ingredients is a good starting place. understanding the meaning of living caring in one's own life is an important base for practicing nursing as caring. in reflecting on a particular lived experience of caring, the nurse can seek to understand the ways in which caring contributed freedom within the situation--freedom to be, freedom to choose, and freedom to unfold. because nursing is a way of living caring in the world, the nurse can turn his or her attention to personal patterns of nursing as expressions of caring. as self understanding as caring person accrues, the nurse sometimes realizes that such self-awareness was there all along--it was only waiting to be discovered. because many nurses were trained to overlook their caring ways instead of attending to them, nurses may now need something similar to, or indeed "sensitivity training" itself, to rediscover and reown the possibilities of self as caring person, possibilities specific to nursing as a profession and a discipline. this redirection of focus away from caring may have been related to several historical social movements. first, of course, is the move toward science, which for nursing meant that for a period of several decades nursing education seemed to reject, either partially or totally, the art of nursing in order to discover a scientific base for practice. another related process, the technology movement, led nurses to understand care as a series of sequential actions designed to accomplish a specifiable end. in this context, nursing care became synonymous with managing available technologies. third, there existed in the history of nursing education an era(s) in which nurses were taught to treat symptoms patients expressed, rather than to care for the person. fourth, maintaining a professional distance was a hallmark of professionalism. now, and rightly so, the tide has turned. a reawakening of knowing self as caring person becomes paramount so that the profession of nursing returns caring to the immediacy of the nursing situation. with personal awareness and reflection, developed knowledge of caring also arrives through empirical, ethical, and aesthetic modes of knowing. there is a growing body of literature in nursing that both attests to that fact and to the process of how nurses communicate caring in practice (e.g., riemen, i a, b; knowlden, ; swanson-kauffman, a, b; swanson, ; kahn and steeves, ). given the various perspectives offered by the authors just mentioned, the individual nurse can enhance his or her ethical self-development as a caring person by cultivating the practice of weighing the various meanings of caring now extant in actual practice situations and then by making choices to express caring creatively. in pursuit of this end, aesthetic knowing often subsumes and transcends other forms of knowing and thus may offer the richest mode of knowing caring. appreciating structure, form, harmony, and complementarity across a range of situated caring expressions enhances knowing self and other as caring persons. knowing self as caring enhances knowing of the other as caring. knowing other as caring contributes to our discovery of caring self. without knowing the other as caring person, there can be no true nursing. living a commitment to nursing as caring can be a tremendous challenge when nurses are asked to care for someone who makes it difficult to care. in effect, it is impossible to avoid the issue of "liking" or "disliking" the patient. is it possible to truly care for someone if the nurse doesn't like him or her? in this light, another question arises: how can enter the world of another who repulses me? am i expected to pretend that this person (the patient) has not treated others inhumanely (if that is the case)? must i ignore the reality of the other's hatefulness toward me (if such exists)? these are questions that come from the human heart. they express legitimate human issues that present themselves regularly in nursing situations. the commitment of the nurse practicing nursing as caring is to nurture persons living caring and growing in caring. again, this implies that the nurse come to know the other as caring person in the moment. "difficult to care" situations are those that demonstrate the extent of knowledge and commitment needed to nurse effectively. an everyday understanding of the meaning of caring is obviously inadequate when the nurse is presented with someone for whom it is difficult to care. in these extreme (though not unusual) situations, a task-oriented, non discipline-based concept of nursing may be adequate to assure the completion of certain treatment and surveillance techniques. still, in our eyes that is an insufficient response--it certainly is not the nursing we advocate. the theory, nursing as caring, calls upon the nurse to reach deep within a well-developed knowledge base that has been structured using all available patterns of knowing, grounded in the obligations inherent in the commitment to know persons as caring. these patterns of knowing may include intuition, scientifically quantifiable data emerging from research, related knowledge from a variety of disciplines, ethical beliefs, as well as many other types of knowing. all knowledge held by the nurse which may be relevant to understanding the situation at hand is drawn forward and integrated into practice in particular nursing situations. although the degree of challenge presented from situation to situation varies, the commitment to know self and other as caring persons is steadfast. caring expressed in nursing is personal, not abstract. the caring that is nursing cannot be expressed as an impersonal generalized stance of good will, but must be expressed knowledgeably. that is, the caring that is nursing must be a lived experience of caring, communicated intentionally, and in authentic presence through a person-with-person interconnectedness, a sense of oneness with self and other. the nurse is not expected to be super-human, superficial, or naïve. rather, a genuine openness to caring and a formed intention of knowing the other as caring person are required. in this sense, and referring back to patients with whom an expression of empathy is problematic; liking may be understood as a less personally committed form of caring or loving. in other words, liking is superficial and may not require the devotion needed to know other as caring. when the nurse truly connects with the other, liking the other becomes a moot issue. stories nurses tell about their nursing bring to light the sustenance they find in the nursing situation. lived experiences of practice, recounted to crystallize the essential meaning of nursing, contain the tangible seeds of awareness of self as caring person. however, the nurse may not be fully aware of self as caring person until the nursing story is articulated and shared. when the practicing nurse can begin to describe practice as the personal expression of caring with and for another, possibilities for living nursing as caring emerge. here is one nurse's response to the invitation to tell a story that conveys the beauty of nursing. the authentic presence of the nurse in the following nursing situation focuses on honesty as an expression of self as caring person. honesty as jason came through the door to rac, a young black man lying lifelessly on a stretcher of pale green linen, the surgeon came towards me telling me not to tell jason that his biopsy was positive. i felt inner terror. a man, less than years old, was going to come close to the "truth" of living today. yet the terror inside me was really fueled by the becoming moral issue i was going to face soon. jason was surely going to ask of the results upon waking from anesthesia. "they always do." going to sleep unknowing demands waking-to-know. "honesty." honesty as a lived precept of caring requires that i, nurse, must always and ever regard the person nursed from a position of love. i must enter all nursing activity with the sole purpose of using truth, only and ever, to promote the spiritual growth of the person nursed. in this climate of openness to myself and to the other, we can begin to experience freedom from fear. jason inevitably opened his eyes only seconds or minutes later--i was so concerned with the surgeon's directive that i lost perception of time. my choice? the surgeon's choice? jason's choice? all too soon, before i could decide "how" to act, jason had arrived at our moment of honesty versus dishonesty. there were tears in jason's eyes and as quickly as the endotrachial tube was removed, words came from jason's essence. "why me, god?" i was pre-empted. (that's what happens when i write the script of nursing.) instead of dancing around "telling" jason, i was now only able to "be-with" jason. to suffer with jason, to come to compassionate knowing of jason's subjective reality. "i heard him," jason choked and sobbed. i just sat next to his stretcher and held his left hand with my right hand. i softly stroked his shoulder. this intimate hand-in-hand gesture only expressed a small part of the instant connectedness that we were co-experiencing, each alone, each with the other, all at once. i sat there for more than thirty minutes telling jason repeatedly to rest, trust god to help him, have strength, courage, and hope. having come together, jason and i, through the darkness of anesthetized sleep to the harsh reality of "wakefulness," we both move on with our lives. i asked the surgeon of jason several times, but he couldn't remember jason. i will never forget jason. jason brought me closer to understanding honesty as caring (little, ). an explicit realization of nursing as a personal expression of caring can fuel a commitment to growing in caring throughout life. a vivid, articulated sense of self connects with an equally strong and explicit sense of nursing, and a personal commitment to caring in and through nursing is created. research makes the unequivocal point that those who seek our nursing service identify caring as the sine qua non of nursing (samaral), ; winland-brown & schoenhofer, ). entering these covenantal relationships obligates us to mutually live and grow in caring. what has also become apparent through our practice is that it is increasingly difficult for nurses to conceptualize their service as caring. many nurses have lost faith in themselves as persons contributing caring in health service delivery situations. thus, the raison d'être for the professional service career of nursing is lost, and nurses become disheartened. it is our experience, as illustrated in the previous story, honesty, that nurses can recapture the spirit of nursing, can rekindle hope for themselves as persons caring through and in nursing. the reader is invited to pause a moment and experience a sense of self as person expressing caring in nursing. you are invited to enter a quiet, contemplative inner space. allow the attentions and distractions of the moment to recede as you create quietude. now, bring to life the most beautiful nursing you have ever done. recall that precious instance that stands out for you as truly nursing. savor the fullness of that experience. explore the meaning of this wonderful experience of nursing. if possible, pause now and tell the story of your finest nursing moment--aloud to another nurse, or in writing to the nurse you are today. share your story and invite other nurses to share theirs with you. now that the moment has been reborn and communicated, it is available as a powerful resource for you. the essence of nursing which connects you to all others in nursing is also to be found here. in that story resides the central meaning of nursing, available now for your inspiration and for your study. for many nurses, the practice of nursing as caring will require changes in the conceptualization of nursing and nursing practice structures. certain ideologies and cognitive frameworks that have gained prominence in nursing in the recent past are not fully congruent with the values expressed in the nursing as caring theory. for example, the problem-solving process introduced into nursing by orlando ( ), known as the nursing process, comes from a worldview that is incompatible with that which undergirds nursing as caring. in the s, nurses came to value orlando's nursing process for its role in helping them organize and put to use a growing body of scientific nursing knowledge. having borrowed the "problematizing" approach to service delivery that was so successful in medical contexts, the nursing process also fit with an emerging documentation system known as problem oriented medical records, which again was adapted from medicine for nursing use. during the late s and through the s, this impetus was further developed in the nursing diagnosis movement. what difficulties exist with the problem-solving process in nursing? more than anything else, this process directs nurses to locate something in the internal or external environment or character of the client that is in need of correction. gadow ( ) refers to this view as a paradigm of philanthropy. in this demeaning paradigm, "touch is a gift from one who is whole to one who is not" (p. ). within the context of orlando's nursing process, such problem solving requires that the nurse find something that needs correction to legitimately offer appropriate care. this focus on correction--and cure--distracts nurses from their primary mission of caring and therefore practice results in objectification, labeling, ritualism, and non-involvement. the context for nursing is lost. further, orlando's process has resulted in nursing's knowledge base being ever more deeply grounded in disciplines other than nursing. an examination of a list of nursing diagnoses reveals that specific knowledge from disciplines such as medicine, psychology, anthropology, sociology, and epidemiology is what is required to solve the problems to which the diagnoses refer. rather than leading nurses toward the development of the knowledge of nursing, orlando's nursing process has intensified the concept of nursing as a context-free integrator of other disciplines. the following story of a nursing situation demonstrates the freedom and creativity that is possible when the nurse takes a focused, unfolding view of the lived world of nursing. what occasioned this nursing relationship was conceptualized in the larger system as providing care for the caregiver, providing support in a family context. here, home nursing is seen as once again on the ascendancy as nurses discover what is increasingly missing in institutional bureaucratic settings--the opportunity to nurse. connectedness i was with j. tonight, and for the first time i enjoyed "authentic presence" with her. i am not so sure it was because i was less fatigued and more receptive to "what is" in her home, but because j. was clearly "different" tonight. she greeted me with her usual rush of activity and then startled me by asking me to "be with me, please," when she gave her son an injection and changed the injection site on his central venous catheter line. i had met her son before, but had never been invited to his room or the upstairs quarters. we spent a long time in a's room with j. and a. talking, sharing thoughts and feelings about (sister) k., frustrations of j. trying to do it all and still find a little peaceful time for herself, angry outbursts and feelings of shame and sadness, and j's desire to go to mass on sunday without feelings of extreme anger and despair because k. cries when j. leaves the house, and ending with j's stated determination to do the impossible task of being all things to all people at all times. the dialogue was really between mother and son, with questions directed toward me but immediately answered by j. and a. the conversation was sparkling with humor and piercing with honesty, and created in mind's eye a rich, colorful mosaic of years of love, beauty, and truth. tonight i wish i were an artist so i could capture this vision on canvas. . asked me to stay with a. while she did a small chore in the kitchen, and i settled in a side chair for whatever might present itself. the i.v. pole in the corner of the room caught my attention and a. offered the name of the drug and its purpose. i honestly did not know that particular drug, and had nothing to offer, so i just nodded my head. a. looked at me, cleared his throat, and proceeded to tell me about a problem he is encountering. i interrupted him and told him that i know nothing about him other than his name and he is j's son, and that j. has not shared anything about him privately with me. he smiled, and then with his head bowed and eyes peering at me, told me that he has aids, worries about the stigma, and dreads the stance most health professionals assume when he encounters them as they interpret the name of his disease process. i sat very still and nodded my head. i wanted to acknowledge his pain and show acceptance of him and what appeared to be his need to connect with me. together we reflected on the wonderfulness of the human spirit, the concept of personhood, and holistic beings with thoughts, feelings, wants, and needs. when a. was ready we ventured down the stairs and found j. sitting quietly in a rocking chair. it seemed she had finished her "task," and i wondered how long she had been sitting alone. i sensed that she had invited me into her private pain, and courageously shared another part of her life with me. i also knew intuitively that she did not want to talk about it. j. had prepared the piano, and all of them asked me to play for them and expressed disappointment that i did not play the piano during my visit last week. so i played gentle, reflective songs interspersed with light melodic phrases. requests were offered by each member of the family, and within minutes j. was sitting next to me on the piano bench, singing loudly and punctuating words with feelings and strength and lending incredible meaning to lyrics. "old man river," deep, low, rumbling of the piano and purposefully driving tempo was responded to in kind with j. stamping her food with each beat and pounding her knee with each word as she emphatically sang "he just keeps rolling along, he keeps on rolling along." it seemed to be cathartic for her as expressions seemed to come from the center of her being. we applauded ourselves when we finished and j. let me hug her. a. caught my eye and mouthed "thank you for helping my mother to smile." j. was quiet then, and i felt her exhaustion. we agreed that it was time to close the piano for another week, and i left. j. followed me to my car, and left me with "god bless you." this was an exhausting visit to j's home, yet it was even more energizing because of the multiple caring moments i experienced with j. and her family. i have come to believe that caring moments are unique to each nursing situation and evolve naturally from the mutuality of authentic presence as the fullness of the nurse's personhood blends with the fullness of the other's personhood. together they transcend the moment. the caring moment is connectedness between nurse and other and both experience moments of joy. (kronk, ) to characterize this nursing situation with a nursing diagnosis and to portray it as a linear process driven by the diagnosis or problem to be addressed with a pre-envisioned outcome would be to rob the situation of all the beauty of nursing. because a story of a nursing situation is narrative, there is a temporal structure. however, this structure supports rather than destroys the "lived experience" character of the situation. the story of the nursing situation conveys the "all-at-once" as well as the unfolding. this approach permits us to conceptualize as well as contextualize the knowledge of nursing the story tells. through story, the meaning for this nurse of knowing herself as caring person, as entering into the world of other(s) with authentic presence, is understood. the nurse knows other as caring person, and in that knowing attends to specific calls for caring with unique expressions of caring responses created in the moment. the nursing as caring theory, grounded in the assumption that all persons are caring, has as its focus a general call to nurture persons as they live caring uniquely and grow as caring persons. the challenge then for nursing is not to discover what is missing, weakened, or needed in another, but to come to know the other as caring person and to nurture that person in situation-specific, creative ways. we no longer understand nursing as a "process," in the sense of a complex sequence of predictable acts resulting in some predetermined desirable end product. nursing is, we believe, processual, in the sense that it is always unfolding and that it is guided by intention. nursing is a professional service offered in social contexts, most often in bureaucratically organized health services. discussions of health services, overheard in boardrooms and legislative chambers, are languaged in impersonal, aggregate, disembodying, and perhaps more importantly, economic terms. in contrast to the accepted ritualization of such language, nursing has a very important role to play--to bring the human, the personal dimension to health policy planning, and health care delivery systems. clearly, it is nursing knowledge itself, of human person, of person as caring, that has been missing. while other groups rightly bring in knowledge of efficient operation and financing, nursing's contribution to the dialogue on effective care has the potential to remind all players of the real bottom line, the person being cared for. we must remember that in most industrialized countries health service is viewed as a commodity delivery system, an economic exchange of goods and services. while this is not the only context for nursing, it is the most prevalent context. if nurses choose to participate in existing delivery systems, and most do, then ways must be created that preserve the service of nursing while responding to the appropriate requirements of the system. ultimately, this would require of nurses that they become skilled in articulating their service as nursing, and connecting that service to the recording and billing systems in use. although this same goal animated the nursing diagnosis movement of the s, within the terms of that movement, the result was less than fortunate: nursing's effort to emulate the fee-for-service billing practices of medicine failed, and nursing contributions were neither communicated nor reimbursed. when nurses tell the stories of their nursing situations, however, the service of nursing becomes recognizable. the unique contribution that nurses make, expressed in the focus of nursing, emerges across settings. the difference between a nursing story and a typical nursing case report is striking; the first conveys the nursing care given, the second reports the medical-assisting activities performed by the nurse. we have discovered in our work with nurses that while nursing care is usually given, it is frequently neither acknowledged nor communicated. the nurse practicing within the caring context described here will most often be interfacing with the health care system in two ways: first, to communicate nursing in ways that can be understood; and second, to articulate nursing service as a unique contribution within the system in such a way that the system itself grows to support nursing. the concept of profession is involved in the practice of nursing as caring. with the advent of the information and action technologies of the twenty-first century, the present concept of professions as repositories of esoteric knowledge employed by social elites is rapidly becoming outdated. as many nurses will attest, the patient often teaches the nurse about new medical technologies and about the management of them. in this regard, what will it mean, in the next century, to profess nursing? a renewed commitment to professional caring means that nurses would seek connectedness in all collegial relationships as nurses are open to discovering the unfolding meaning of human caring, with persons valued as important in themselves. therefore, nurses forfeit assuming authoritative stances toward each other, the persons nursed, and other participants in the health care enterprise. more than ever, it will mean that nurses will, in relation with others, live out the value of caring in everyday life. thus, the organized nursing profession would assume responsibility for developing and sharing knowledge of nurturing persons living caring and growing in caring. the following story of a nursing situation, told in the form of a poem, exemplifies the reconceptualization called for in the practice of nursing as caring. in this situation, the nurse carried out a medically prescribed treatment, not as a form of medicine but as a form of nursing. the nurse communicates a knowing of the other as caring person, living courage and hope in the face of pain and fear. this example illustrates the meaning of knowing as a caring ingredient (mayeroff, ), in the connectedness of the nurse with the patient. the nurse's knowing both forms the intention to nurse and is formed by the intention to know other as caring person and nurture caring. a more typical recounting of this situation would focus on the specific procedure of the treatment being applied, in terms of the condition of the wound. in this poem, the nurse renders the meaning of nursing. heating--hiv + your wounds weeped purulent with the discharge of our pain and fear. they tried to hide, only to reappear. the treatment gentle, slow a warm, loving balm to your soul. your stomach was fed the comfort food of your youth and your lips drank in deeply all you knew and understood. the memories sweetened each moment you stood, face to face with terror of what might be mistook. all inside shifted as slowly it came, a gradual awakening; embracing of pain as you conquered your demons a lightness appeared to stay forever and abolish all fears. (wheeler, ) nursing service administration many of the nursing situations described in this book have taken place in hospital settings, where the nursing service is a shared responsibility of many nurses in a range of functional roles. nurses in such settings generally nurse many persons intensively and simultaneously and share direct nursing responsibility with one or two other nurses. how can nurses in institutional practice settings be supported so that calls for nursing can be heard and nursing responses made? what is the role of the nurse administrator in supporting the practice of nurses? it is important to understand clearly the difference between the practice of administration which happens to be delivered by nurses and the practice of nursing administration. tead ( ) defines administration as "the comprehensive effort to direct, guide, and integrate associated human strivings which are focused toward some specific ends or aims" (p. ). for example, goals of administration could be business, governmental, education, or nursing. in this definition, it is evident that the focus must be made clear. it is not adequate to have an understanding of administration as a role which is focused in functions such as interpersonal, informational, and decisional. such a perspective ignores the value of persons and the ministering responsibilities inherent in the role. the administrator must connect his or her work to the direct work of nursing. nursing administration by name suggests a groundedness in the discipline. the role of the nursing administrator could indeed be questioned if the focus of the administrative practice is not nursing. there is the assumption that the administration of nursing is practiced from a particular conception of nursing in which the focus or goal of nursing is clear. what the nursing administrator says and does as nurse must reflect the uniqueness of the discipline so that nursing's unique contributions are assured. nursing administrators must also be able to articulate the unique contributions of nursing to other members of the interdisciplinary health care team. the relationship of the nurse administrator's role to direct care is implicit in this perspective. the nursing administrator describes him or herself as directly involved in the care of persons. all activities of the nursing administrator are ultimately directed to the person(s) being nursed. it is essential that this direct connection to the goal of nursing be made and that persons assuming nursing administration positions be able to articulate their unique role contributions to nursing care. without this clarity of focus, one may be engaged in the practice of administration but not nursing administration. from the viewpoint of nursing as caring, the nurse administrator makes decisions through a lens in which the focus of nursing is nurturing persons as they live caring and grow in caring. all activities in the practice of nursing administration are grounded in a concern for creating, maintaining, and supporting an environment in which calls for nursing are heard and nurturing responses are given. from this point of view, the expectation arises that nursing administrators participate in shaping a culture that evolves from the values articulated within nursing as caring. although often perceived to be "removed" from the direct care of the nursed, the nursing administrator is intimately involved in multiple nursing situations simultaneously, hearing calls for nursing and participating in responses to these calls. as calls for nursing are known, one of the unique responses of the nursing administrator is to directly or indirectly enter the world of the nursed, understand special calls when they occur, and assist in securing the resources needed by the nurse to nurture persons as they live and grow in caring. all nursing activities should be approached with this goal in mind. here, the nurse administrator reflects on the obligations inherent in the role in relation to the nursed. the presiding moral basis for determining right action is the belief that all persons are caring. frequently, the nurse administrator may enter the world of the nursed through the stories of colleagues who are assuming other roles such as nurse manager. policy formulation and implementation allow for the consideration of unique situations. the nursing administrator assists others within the organization to understand the focus of nursing and to secure the resources necessary to achieve the goals of nursing. when the focus of nursing can be clearly articulated, nursing's contribution to the whole will be understood, if the focus of practice is clouded, however, this becomes an insurmountable task. recognition of nursing's value is contingent upon the ability of nurses to articulate their contribution. traditionally, systems define contribution through patient outcomes and other total quality measures. future articulation of nursing and its contributions would emanate from the values and assumptions offered in the nursing as caring theory. sharing nursing situations with others is one way to promote the knowing of nursing. it also is a way for other members of the organization to see how their roles contribute to the well-being of the nursed. the following is a nursing situation, re-presented as the poem "last rights," that cries out for nursing administration, that is, nursing support for nursing. last rights tight faced, they found and cornered her at work as quick as hammers pounding down a wall of words came hard and nailed that little quirk of honest so fast she held the rail. "who were you to say he was a dying man, though he lay white, his lifethread thin. how were you to know the speed his flying heart would race away from bone and shin. he was hopeless, yes, beneath that tent of filmy gauze, but who were you to say his fate was hinged in prayer-our magic spent. who knows, he might have lived another day. "he held my hands, asked the truth," she said. then turned away to smooth the empty bed. --yelland-marino ( ) the nurse administrator can nurture the living in caring and growing in caring of the person in this story by creating ways to support the nurse at the bedside in order that the call for hope of being known and supported as caring person, not object, can occur. what are some of the strategies that the nurse administrator could engage in which would reflect the nursing focus? because budget determination is such a prominent matter for nurse administrators, we will begin there. budget decisions should be directed from the perspective of what i ought to do as nurse administrator that would have the greatest effect on nurturing persons being cared for in their living and growing in caring. one aspect of budget essential to this story is time--time for the nurse to focus on knowing self and other colleagues. as paterson & zderad ( ) state, for nursing practice to be humanistic, awareness of self and others is essential. the budget should include time allocations for staff to participate in dialogues focused on knowing self as caring person in order that calls, such as the one in the previous story, can be heard. the notion of dialogue is central to transforming ways of being with others in organizations. bohm ( ) refers to dialogue as creating "a flow of meaning in the whole group, out of which will emerge some new understanding, something creative" (p. ). persons engaged in dialogue are focused on trying to understand situations as perceived through another's eyes in order that new possibilities may be recognized. through the allocation of time, nursing staff come to better know self and other. shared meanings emerge which become the "glue or cement that holds people and societies together" (p. ). these opportunities for knowing self assist the nurse to achieve, as tournier ( ) would put it, a reciprocity of consciousness with other. through the opportunity to better know self as caring person, the nurse will learn to intentionally and authentically enter nursing situations focused on knowing and supporting the nursed as they live caring and grow in caring. time for reflection and collegial dialogue is necessary to maintain this nursing lens in a period of increasing responsibility. such time allocation communicates the commitment of the nurse administrator to enhance the growth of the nurse in the discipline of nursing. to propose that the budgeting of time is one of the most essential tasks of a nursing administrator may seem outrageously naïve in a time when organizations seem to be interested only in bottom-line figures. ironically, however, the time allocation strategy offered here supports the goal of cost containment. studies have shown that caring behaviors of nurses (duffy, ) and nursing staff attitudes (cassarea et al., ) are directly related to patient satisfaction. benner and wrubel ( ) also found that caring is integral to expert practice. as a result, and from the standpoint of quality of care as revenue producing, this strategy of allowing time for dialogue and reflection has merit. from the viewpoint of the nursing as caring theory, the nurse administrators' beliefs about person would require that new ways of being with the nursed are created and supported. the nursing administrator models a way of being with others that portrays respect for person as caring. through modeling, others grow in their competency to know and express caring. of course creating and sustaining environments that nurture and value the practice and study of nursing remains the challenge facing nurses caught in the maze of various organizational structures. systems tend to perpetuate existing ways of being even though their members may repeatedly question the legitimacy of actions flowing from these structures. it is our belief that nursing can create a culture that values caring within systems and organizations. systems and organizations can be reshaped and transformed through living out the assumptions and values inherent within nursing as caring. assumptions on which nursing as caring is built serve as stabilizers for the organization. these assumptions directly influence the climate of the organization and serve as the organizational pillars. the climate of organizations is determined by beliefs and values of persons within it. an organization grounded in the assumptions of person as described in chapter would not support arbitrary and capricious decision making in which the input of all persons has not been discerned. mission statements, goals, objectives, standards of practice, policies and procedures emerge from assumptions, beliefs, and values that emphasize one's humanness. if one accepts the assumption that persons are caring by virtue of their humanness, then it follows that cultures are comprised of caring persons. respect for person as person is engendered within this context. there is a desire to know and support the living of caring; to support each other in being who we are as caring persons in the moment. therefore, assumptions of nursing as caring ground not only the theory but may likewise influence the ontology of the organization itself. generally, organizational structures reflect bureaucratic values. structures imply ways of being with and relating to people. the process of relating is typically illustrated in a hierarchical fashion. the concept of hierarchy carries with it the notion that there is a "top" and a "bottom." competition, levels, and positions of power are implicit. in climbing the rungs of a bureaucratic ladder, it is difficult for the employee to be authentic and valued as a unique person with special ideas because the risks of such valuing are often too great for the bureaucracy to bear. competition too remains the driving force of most organizations. within an organization, however, we can imagine each person's hands as clinging to the rungs of the bureaucratic ladder. taken further, this image would clearly portray persons who are not and can not be open to receive and know other. because of the vertical axis of the bureaucratic hierarchy, persons, more often than not, are viewed as objects. the ladder positions people so that they are either looking up or down but rarely eye-to-eye. obviously, the hierarchical model does not support the idea of each person as important in and to him or herself. by contrast, and from the assumptions posited in nursing as caring, the model for being in relationships resembles a dance of caring persons (boykin, ). the same persons are present in this circle that were in the hierarchical structure described above. the difference between the two models is the philosophical way of being with other. because the nature of relating in the circle is grounded in a respect for and valuing of each person, the way of being is diametrically opposed to traditional patterns of relating in organizations. leaving the security provided by known hierarchical structures, however, requires courage, trust, and humility. building on the assumptions of this theory, one can infer that the basic dance of all persons in relationships is to know self and other as caring person. each person is encouraged and supported in a culture that values person-as-person, person as caring. [illustration: dancing circle] the image of a dancing circle is also used to describe being for and being with the nursed. in the circle, all persons are committed to knowing self and other as living and growing in caring. each dancer makes a distinct contribution because of the role assumed. the dancers in the circle do not necessarily connect by holding hands although they may. each dancer moves within this dance as called forth by the nature of the nursing situation. the nursed calls for services of particular dancers at various points in time. each person is in this circle because of their unique contribution to the person being cared for ... nurses, administrators, human resources, etc. these roles would not exist if it were not for the nursed. there is always room for another person to join the dance. rather than the vertical view described earlier, this model fosters knowing other. eye-to-eye contact assists one to know and appreciate each other as caring persons. each person is viewed as special and caring. no one person's role is more or less important than the other's. each role is essential in contributing to the process of living grounded in caring. as each person authentically expresses their commitment in being there for and with the nursed, caring relationships are lived. when the focus in any health care institution fails to be the person cared-for, purpose, roles, and responsibilities become depersonalized and bureaucratic rather than person-centered and caring. personal knowing--knowing of self and other--is integral to the connectedness of persons in this dance. the nursing administrator interfaces with persons of many disciplines as well as with the nursed. with each interaction, the nurse administrator is honest and authentic in encouraging others to know and live out who they are. each encounter with another is an opportunity for knowing other as caring person. from an organizational standpoint the nursing administrator assists in creating a community that appreciates, nurtures, and supports each person as they live and grow in caring moment to moment. the nursing administrator assists nurses to hear and understand the unique calls for nursing and supports and sustains their nurturing response. references benner, p, & wrubel, j. ( ). the primacy of caring: stress and coping in health in illness. ca: addison-wesley. bohm, d. ( ). on dialogue. noetic sciences review, pp. - . boykin, a. ( ). creating a caring environment: moral obligations in the role of dean. in m. leininger & j. watson (eds.), the caring imperative in education. new york: national league for nursing, pp. - . cassarrea, k., millis, j., & plant, m. ( ). improving service through patient surveys in a multihospital organization. hospital and health services administration, ( ), - . duffy, j. ( ). the impact of nurse caring on patient outcomes. in gaut, d. (ed.). the presence of caring in nursing. new york: national league for nursing, pp. - . gadow, s. ( ). touch and technology: two paradigms of patient care. journal of reli- gion and health, , - . kahn, d., & steeves, r. ( ). caring and practice: construction of the nurse's world. scholarly inquiry for nursing practice, ( ), - . knowlden, v. ( ). the meaning of caring in the nursing role. dissertation abstracts international, ( ), -a. kronk, p. ( ). connectedness: a concept for nursing. unpublished manuscript. little, d. ( ). nurse as moral agent. paper presented at university of south florida year of discovery seminar, sept. . mayeroff, m. ( ). on caring. new york: harper & row. orlando, i ( ). the dynamic nurse-patient relationship. new york: g.p. putnam's sons. paterson, j., & zderad, l. ( ). humanistic nursing. new york: national league for nursing. riemen, d. ( a). noncaring and caring in the clinical setting: patients' descriptions. topics in clinical nursing, , - . riemen, d. ( b). the essential structure of a caring interaction: doing phenomenology. in p. munhall & c. oiler (eds.). nursing research: a qualitative perspective. norwalk, ct: appleton-century-crofts. roach, s. ( ). the human act of caring. ottawa: canadian hospital association. samarel, n. ( ). caring for life and death: nursing in a hospital-based hospice. dissertation abstracts international, ( ), -b. swanson-kauffman, k. ( a). caring in the instance of unexpected early pregnancy loss. topics in clinical nursing, , - . swanson-kauffman, k. ( b). a combined qualitative methodology for nursing research. advances in nursing science, , - . swanson, k. ( ). providing care in the nicu: sometimes an act of love. advances in nursing science, ( ), - . tead, . ( ). the art of administration. new york: mcgraw-hill. tournier, p. ( ). the meaning of persons. new york: harper & row. wheeler, l. ( ). healing-hiv+. nightingale songs, p.o. box , west palm beach, fl - , ( ). winland-brown, j., & schoenhofer, s. ( ). unpublished research data. yelland-marino, t. ( ). last rights. nightingale songs, p.o. box , west palm beach, fl - , ( ). [illustration: button] chapter v. -- implications for nursing education in this chapter, we address the implications of our theory for nursing education, including designing, implementing, and administering a program of study. the assumptions that ground nursing as caring also ground the practice of nursing education and nursing education administration. the structure and practices of the education program are expressions of the discipline and, therefore, should be explicit reflections of the values and assumptions inherent in the statement of focus of the discipline. from the perspective of nursing as caring, all structures and activities should reflect the fundamental assumption that persons are caring by virtue of their humanness. other assumptions and values reflected in the education program include: knowing the person as whole and complete in the moment and living caring uniquely; understand that personhood is a process of living grounded in caring and is enhanced through participation in nurturing relationships with caring others; and, finally, affirming nursing as a discipline and profession. the curriculum, the foundation of the education program, asserts the focus and domain of nursing as nurturing persons living caring and growing in caring. all activities of the program of study are directed toward developing, organizing, and communicating nursing knowledge, that is, knowledge of nurturing persons living caring and growing in caring. the model for organizational design of nursing education is analogous to the dancing circle described earlier. members of the circle include administrators, faculty, colleagues, students, staff, community, and the nursed. what this circle represents is the commitment of each dancer to understanding and supporting the study of the discipline of nursing. the role of administrator in the circle is more clearly understood when the origin of the word is reflected upon. the term administrator is derived from the latin ad ministrare, to serve (guralnik, ). this definition connotes the idea of rendering service. administrators within the circle are by nature of role obligated to ministering, to securing and to providing resources needed by faculty, students, and staff to meet program objectives. faculty, students, and administrators dance together in the study of nursing. faculty support an environment that values the uniqueness of each person and sustains each person's unique way of living and growing in caring. this process requires trust, hope, courage, and patience. because the purpose of nursing education is to study the discipline and practice of nursing, the nursed must be in the circle. the community created is that of persons living caring in the moment, each person valued as special and unique. we have said in chapter that the domain of a discipline is that which its members assert. the statement of focus that directs the study of nursing from this theoretical perspective is that of nurturing persons as they live caring and grow in caring. the study of nursing is approached through the use of nursing situations. the knowledge of nursing resides in the nursing situation and is brought to life through study. the nursing situation is a shared lived experience in which the caring between the nurse and the one nursed enhances personhood or the process of living grounded in caring. these situations, like the many cited in earlier chapters, become available for study through the use of story (recounting the situation in ways that convey the essence of the lived experience). these stories create anew the lived experience of caring between the nurse and the nursed, and bring to life the basic values described in chapter . story then becomes the method for studying and knowing nursing. carper's ( ) four patterns of knowing serve as an organizing framework for asking epistemological questions of caring in nursing. those patterns include personal, ethical, empirical, and aesthetic knowing. each of these patterns comes into play as one strives to understand the whole of the situation. personal knowing centers on knowing and encountering self and other, empirical knowing addresses the science of caring in nursing, ethical knowing focuses on what "ought to be" in nursing situations, and aesthetic knowing is the integration and synthesis of all knowing as lived in a particular situation. the poem, "intensive care," a representation of a nursing situation, is given here to illustrate the organization of sample content. intensive care (centered) did you see nurse that you can know me-- the part that is me, my mind and soul is in my eyes these tubes that are everywhere-that is not me. the one in my throat is the worse of all-- now my whole being, the essence of me i must reflect through my hands but they are tied down, movements of my head but did you realize that uncomfortable for me or through my eyes and you do not notice them-- except once today during my bath. you speak to me and look at the tubes-- don't you know my thoughts are all over my face don't you realize your thoughts are on your face-- in your touch and your tone of voice. i wrote a request on paper and you said "i'll take care of it for you" your tone said "why can't this woman do anything for herself?" you positioned your hand to count my pulse but i can't say you touched me-you wouldn't hold my hand that i may touch you. you walked in for the first time today with a grin on your face but your mouth is now tight you grimaced a lot as you bathed me. don't you see nurse that you can know me--i'm not a chart or tubes of medication, monitors or all the other things you look at so intensely--i'm more than that i'm scared--just look in my eyes. --s. carr, carper's ( ) patterns of knowing offer a framework for organizing the content for studying this nursing situation. personal knowing who are the nurse and nursed as caring persons in the moment? how are the nurse and nursed expressing caring in this moment? what is the meaning of this situation to the nurse and nursed in terms of present realities and future possibilities? what is the meaning of vulnerability and mortality? what is the value of intuition in practice? empirical knowing what nursing and related research exists on modes of communication, the meaning of presence in practice, touch, objectification, recovery of cardiac patients, technological caring, understanding the experience of fear and loneliness? what factual knowledge is needed to be competent in this particular situation--e.g. knowledge of monitors, chest tubes, medications, cardiac care, diagnostic data? ethical knowing if nursing is practiced from the perspective of nursing as caring, what obligations are inherent in this situation? how is the nurse demonstrating the value that all persons are caring? respect for person-as-person? interconnectedness? what dilemmas are present in this story? aesthetic knowing how is the nursed supported to live dreams of living and growing in caring? how could the nurse transcend the moment to create possibilities within this specific nursing situation? what metaphors might express the meaning of this nursing situation? students studying this nursing situation are challenged to know the person as caring, as living caring uniquely in the moment, as having hopes and dreams for growing in caring, and as being whole or complete in the moment. the student is also challenged to know the nurse as caring person in the moment and to project ways of supporting the nurse as caring person. through the study of this situation, students and faculty identify a range of calls for nursing as well as nurturing responses. in this process, there is dialogue focused on knowing the nurse and nursed in the story as caring person. we would contribute the following as our knowing of the nursed as caring person. through her honest expression of "i'm scared--just look in my eyes," we know her as living hope, honesty, and transcending fear through courage. calls for nursing might include a call to be known as caring person and a call to have interconnectedness recognized and affirmed. the nurse's response to these calls is individual and evolves from who one is as person and nurse. therefore, the range of responses is multiple and varied--each reflecting the nurse's informed living of caring in the moment. each nurturing response is focused on nurturing the person as he or she lives caring and expresses hopes and dreams for growing in caring. if the nurse is responding to the call of the person for recognition and affirmation of interconnectedness, perhaps the nurse would express hearing this call by being present with the intention of knowing other as caring person. this may be communicated through active patience--giving the other time and space to be known; through touch which communicates respect and interconnectedness; through the nurse sharing who he or she is as caring person in this relationship--perhaps through tears as the resonance of commonality of this experience is known; through music or poetry if a shared love of these has been discovered. through dialogue, students and faculty openly engage in the study of nursing. the dialogue encourages and supports students and faculty to freely express who they are as person and nurse living caring through the re-presented story. it provides an opportunity to affirm values of self and discipline and to study how these values may be lived in practice. it is in this dialogue of nursing that faculty communicate their love for nursing. time is needed for both faculty and students to reflect on the meaning of being a member of this discipline and more specifically, on the meaning of being a member of a discipline focused on nurturing persons as they live and grow in caring. dialogue facilitates the integration of this understanding and is a key concept in present and future transformations of nursing education. common engagement in dialogue as nursing stories are shared and studied is the way of being. the story lived anew provides students the opportunity to participate in a lived experience of nursing and to create new possibilities. since nursing can only occur through intentionality and authentic presence with the nursed, students and faculty share how they prepare to enter the world of the nursed, and how they come to understand that world. this process requires that students be encouraged to live fully their personhood. to facilitate such living, faculty support an environment in which students are free to choose and to express self in various ways. for example, perhaps the holistic understanding of a nursing situation would be expressed as aesthetic knowing through dance, poetry, music, painting, or the like. we view this process of education as critical to moral education. when students enter nursing situations to know other as living and growing in caring, they are living out the moral obligation that arises from the commitment to know person as caring. here, then, is an expression of a dynamic view of morality in which caring is always lived in the moment. in the study of the situation, intensive care, brought to the dialogue are personal experiences of being alone, being afraid, and being with someone and not being heard or seen as caring person. this personal knowing fosters human awareness of our connectedness and interdependence. in this context, the nurse does not study the empirics of cardiac pathology to understand a perceived deficit but rather to become competent in drawing forth the knowledge that is specific to knowing this person as whole in the moment. the nurse comes to know the person as living caring and growing in caring, situated within a particular set of circumstances, some of which the nurse knows explicitly. each student entering the nursing situation will ask, "how can i nurture this person in living and growing in caring in this situation?" because each nurse may hear calls for caring in many different ways, nursing responses are many and varied. for nursing faculty, openness to multiple possibilities presents a particular challenge and an opportunity to suspend entrenched patterns of teaching nursing. faculty and students study nursing together. faculty join students in a constant search to discover the content and meaning of the discipline. undoubtedly, this understanding of extant possibilities presents a different view of the role of teacher. yet, it is a view that engenders the sort of humility essential to nursing for there is always more to know. although past methods of teaching of nursing may have been comfortably structured through textbooks organized around medical science, faculty are now empowered to question what should be the focus of study in the discipline of nursing. faculty are encouraged to take risks and let go of the familiar. the perspective that nursing as caring conveys--the fullness and richness of nursing--will allow faculty to willingly assume the risks inherent in a new way of guiding the study of nursing. in teaching nursing as caring, faculty assist students to come to know, appreciate, and celebrate self and other as caring person. mayeroff's on caring ( ) provides a context for the generic knowing of self as caring. through dyads or small groups, students share life situations in which they experienced knowing self and other as caring person. mayeroff's caring ingredients (knowing, alternating rhythm, trust, honesty, hope, courage, humility, patience) also serve as a source for reflection as one asks "who am i as caring person?". as students engage in this exercise, their emerging reflections begin to ground them as they grow in their understanding of person as they live and grow in caring. students will also draw on the knowledge gleaned in the study of arts and humanities as they attempt to gain a deeper understanding of person. the process of knowing self and other as caring is lifelong. in an educational program grounded in nursing as caring, however, the focus on personal knowing (in the study for every nursing situation) provides a deliberate opportunity for greater knowing of self and other as caring person. students, as well as faculty, are in a continual search to discover greater meaning of caring as uniquely expressed in nursing; journaling is an approach that facilitates this search. for example, in a special form of journaling, students actively dialogue with authors whose works they are reading and with the ideas expressed in their works. this process enhances the students' understanding of caring in nursing. over time, students integrate and synthesize many ideas and create new understandings. examination is another process to facilitate learning. from this theoretical perspective, essay examinations that present nursing situations provide opportunities for students to express their knowledge of nurturing persons living and growing in caring. aesthetic projects also allow the student the opportunity to communicate understanding of a nursing situation. we would like to share with you a project from a course in which the students were asked to express the beauty of a nursing situation. in this nursing situation, the nurse, michelle, shared her gifts of therapeutic touch and voice as expressions of caring for david in the moment, drawing on an earlier dialogue in which david told her of his love of meditation and the ave maria, she wrote: ave maria and therapeutic touch for david "david, let me know your pain; from fractured leg and heart, share with me your private hell. next to one who's far, far away his own world: moaning, crying, weak. what's it like to lie beside one who cannot speak? "tell me david, what you do to cancel out the sound; eliminate the smell of dung in which your roommate's found? who can you complain about? are you worse off than he? tied to iv, traction lines you cannot be free. "david, i can see your pain. tell me where you are. tied in bed. powerless. from loved ones you're apart. i can't move you from this place to take your pain away. but let me lay my hands on you and sing to you today." ave marie, gratia plena maria, gratia plena. ave dominus, dominus tecum. benedicta to in mulieribus. et benedictus et benedictus, fructus ventris; ventris tui, jesu. ave maria i sang the song he loved and used to meditate and flee, escape tormenting stimuli. he needed to be freed, to understand why he must bear this trial, this hell, this pain, i sang the tune; i touched with care to give him peace again. --stobie, expressions of nursing such as this, which was partly sung, beautifully portray the living of caring between the nurse and the nursed and exemplify how caring enhances personhood. faculty play a vital role in fostering in students the courage to take such risks. faculty encourage self-affirmation in students, open, nonjudgmental dialogue, living the caring ideal in the classroom and development of the students' moral groundedness in caring (boykin & schoenhofer, ). faculty also take the risk of sharing self through their stories of nursing. the sharing of nursing situations is, in essence, a sharing of our innermost core of common identity and forms a type of collegiality among those who are studying the discipline together. how can faculty be supported to teach nursing in new ways? the administrator of the program fosters a culture in which the study of the discipline from the caring perspective, as presented here, can be achieved freely and fully. all actions of the dean are directed toward creating, maintaining, and supporting this goal. the theoretical assumptions ground the activities of the dean in both internal and external areas of responsibility. internally, the administrator, faculty, staff, and students model commitment by creating an environment that fosters the knowing, living, and growing of persons in caring. the dean "ministers" by assuring that faculty, students, and staff are presented ongoing opportunities to know themselves ontologically as caring persons and professionals and to understand how caring orders their lives. who we are as person influences who we are as student, colleague, nurse, scholar, and administrator. therefore, attention must be directed to knowing self. time must be devoted to knowing and experiencing our humanness. the constant struggle to know self and other as caring person nourishes our knowing of the nursed. through constant discovery of self, the other is also continually discovered. this culture sensitizes each person to ways of being with other that necessitate that each action reflect respect for person as person. therefore, when issues are to be addressed, they are addressed openly and fully. persons are encouraged to bring forth who they are so there is congruence between actions and feelings. understanding each other's views is essential to the unfolding of this culture. dialogue assists one to know the other's needs and desires, and to image oneself in the other's place. as such, the dean, faculty, staff, and students become skilled in the use of the caring ingredients, internalized as personally valid ways of expressing caring: knowing, alternating rhythms, trust, hope, courage, honesty, humility, and patience (mayeroff, ). of utmost importance in fostering this culture are decisions regarding selection of faculty. although many prospective faculty have a fairly traditional lens for the study of nursing (that is, the lens of medical science or frameworks borrowed from other disciplines), this actually becomes an insignificant factor in the process of selection. at the heart of choosing new faculty is knowing their passion for and love of nursing. a focus of the interview process is discerning the person's devotion to the discipline. it is our belief that this attitude, this love of nursing, is the music for the dancers in the circle. one way to know if prospective faculty love nursing is to ask them to share a significant story from practice. having faculty share a story illuminates their conceptualization of the discipline. many faculty who have not had the opportunity to teach nursing through an articulated nursing lens, can yet communicate nursing clearly through story. faculty are supported in their struggles to conceptualize nursing in a new way. forums in which faculty come together and aesthetically re-present and share their nursing story is one strategy that effectively engages self and other in the knowing of nursing. it is also a wonderful way to orient faculty as to how to use nursing situations to teach nursing. faculty support each other as colleagues in learning to teach nursing in a new way, in becoming expert in the practice of nursing education, and in living out the basic assumptions of this theory. this need for support holds true not only for faculty-faculty relationships but for all relationships. the comfort of faculty teaching nursing from the perspective of nursing as caring is enhanced as the value of knowing other as caring, as living our histories and as having special nursing stories to share is appreciated. the administrator, faculty, and staff assist in fostering an environment that furthers the development of the students' capacity to care. competency in caring is a goal of the educational process. students are continually guided to know self and other as caring person as faculty and administrators model actions that reflect respect for person as person. each student is known as caring person, as special and unique. policies allow for consideration of individual situations and diverse possibilities. in this culture, the dean and faculty attempt to know the student as caring person and student of the discipline. the intention of the dean to know students in this way can be evident through invitations for regularly scheduled dialogue in which students share openly their conceptions about nursing. the administrator is truly with students to know them as caring persons and to hear from them their understanding of nursing as caring. externally, the dean "ministers" to faculty, students, and staff through securing resources necessary to accomplish program goals. the dean articulates to persons in the academic and broader community their role in the dance of nursing. the role of these persons is to provide resources such as scholarships, faculty development possibilities, learning resources, and research monies. although this may be a primary responsibility of the dean by nature of the role, all persons in the circle share in this process by virtue of their commitment to nursing. the administrator brings to the circle a skillful use of the caring ingredients. alternating rhythms are used to understand and appreciate each person's unique contributions that support the achievement of program goals. for example, the budgetary process is essential to creating an environment that reflects the valuing of nursing. commitment of the dean to securing resources necessary to accomplish the program goals drives the budget rather than the budget driving the commitment. the administrator's devotion to the discipline and to the basic assumptions of the theory direct all activities. the administrator makes decisions that reflect the basic beliefs of this theory. all decisions would ultimately be made from this standpoint: "what action should i take as administrator which would support the study of nursing as nurturing persons living in caring and growing in caring?" what we have tried to suggest here is that every aspect of nursing education is grounded in the values and assumptions inherent in this theoretical focus. thus, not only is the curriculum a direct expression of nursing as caring, but all aspects of program are similarly grounded. references boykin, a., & schoenhofer, s. ( ). caring in nursing: analysis of extant theory. nursing science quarterly, , - . carper, b. ( ). fundamental patterns of knowing in nursing. advances in nursing science, , - . carr, s. ( ). intensive care. nightingale songs, po. box , west palm beach, fl - , ( ). guralnik, d. ( ). webster's new world dictionary of the american language. cleveland: william collings + world publishing co. mayeroff, m. ( ). on caring. new york: harper & row. nodding, n. ( ). an ethic of caring and its implications for institutional arrangement. american journal of education, , - . roble, m. ( ). ave maria and therapeutic touch for david. nightingale songs, p.o. box , west palm beach, fl - , ( ). [illustration: button] chapter vi -- theory development and research in this chapter, we will address our conception of nursing as human science and suggest directions and strategies for further development of the theory of nursing as caring. we initially introduced our perspective of nursing as discipline and profession in chapter and as a grounding context for the theory. as a discipline, nursing is a way of knowing, being, valuing, a way of living humanely, connected in oneness with others, living caring and growing in caring. the unity nursing offers is known in human experience through personal, empirical, ethical, and aesthetic realms. science has to do with knowing and that which is known. philosophers of science are concerned with valid ways of knowing and ways of validating that which is known. human science is described by scholars in various ways, each emphasizing particular values but all connecting to a common understanding that human science is concerned with knowing the world of human experience. a committed inquiry into human experience seems to call forth certain values related to the meaning of being human. herein lies the fundamental difference between formal science and human science, as we perceive it. formal science, that which is practiced in the natural sciences and other sciences that emulate them, is modeled on the structure of mathematics. mathematics is a highly lawful science that has contributed enormous social benefits over time. however, formal science grounded in mathematics and languaged as calculus is an inappropriate approach to the study of person-as-person. a perspective that addresses the phenomenon of person-as-person is grounded in central values such as caring, freedom, and creativity. methods to study person must be similarly grounded. we have come to understand that valid ways of knowing nursing and legitimate warrants for nursing knowledge are discovered from within the study of nursing itself; that is, within the study of the nursing situation. the manner in which certain disciplines are conceptualized, especially those dealing in normative contexts, calls for a dialectical form of sciencing, comparing, and contrasting. however, coming to know nursing is a dialogical process--direct engagement with the "word of nursing." nursing science must be contextual; the decontextualized methodology of formal science, while essential for certain disciplines, cannot reveal direct knowledge of nursing. because of the nature of nursing, nursing science must permit intentionality, intimacy, mutuality, and particularity. human science has understanding as its goal, with the definite expectation that understanding is in the moment only (watson, ; van manen, ). in addition, the nature of nursing praxis does not require knowledge for the purpose of control, but for enlightenment, moment-to-moment and reflectively. the nurse seeks knowledge neither to control one's own behavior or that of the nursed. if it were otherwise, the nurse would become his or her own prisoner, and would relate to the other as dominator rather than caring nurse. the concept of the hermeneutic circle informs our understanding of the nature of nursing as a human science. this circle of understanding, really a sphere more than a uni-dimensional circle, is a heuristic device which directs our attention. as attention pauses at any aspect of the nursing situation, we must attend to other aspects and to the whole of the nursing situation to create useful understanding. one hermeneutist has pointed out that the circle brings us further along, not the issue at hand (droysen, ). this distinction points to the human science position that understanding is not constituted through analysis of facts but through dialogue with text and context. that is, what moves within the circle is the seeker, rather than that which is sought, so that many aspects are illuminated in context, and understanding grows. the hermeneutic circle requires that what we note in our inquiry remains contextualized, developing "new and ever new circles" (boeckh, ). this is in contrast to normal science that requires an external referent for objects of study in order to avoid circular thinking. heidegger ( ), for example, contrasts the vicious circle of normal science (tautology) with the circle of hermeneutic: " . . . in the circle is hidden a positive possibility of the most primordial kind of knowing" (p. ). we would propose that valid knowing in nursing is that which is known from within the circle. while the work of several scholars has influenced our understanding (e.g., gadamer, ; van manen, ; ray, ; reeder, ), macdonald's ( ) interpretation from the field of humanistic education is especially meaningful. he explains hermeneutic knowing methodologically as "circular rather than linear in that the interpretation of meaning in hermeneutic understanding depends on a reciprocal relation" (p. ) rather than on a fixed normative reference point. the hermeneutic circle models the idea of reciprocal relation, but macdonald goes further to call for a self-reflective science that will "transcend problems of monological and hermeneutic meaning" (p. ). the nature of nursing as expressed in the nursing as caring theory is a reciprocal relation, one characterized by its grounding in person as caring, and as persons connected in oneness in caring. sciencing in nursing from this perspective must go beyond linearity to encompass the dialogic circling involved in the nursing situation. this places the discipline of nursing among the human sciences, and calls for methods of inquiry that assure the circle or dialogue, and further, fully accommodate that which can be known of nursing. nursing is properly catalogued as one of the human sciences for many reasons. the most basic reason is that the discipline and the disciplined practice of nursing directly involve persons in the fullness of their humanness. from our perspective, this means person as caring. person as caring implies person in community, connected in oneness with others and with the universe, person freely choosing the living of values which are expressions of caring. this nursing ontology requires an epistemology consonant with human science values and methods. to know of, through and with nursing necessitates methods and techniques that honor freedom, creativity, and interconnectedness. in chapter , we asserted that nursing knowledge is created and discovered within and from within the nursing situation. (nursing situation, you may recall, is understood as a shared lived experience in which the caring between the nurse and the one nursed enhances personhood.) therefore, because the locus of nursing inquiry is the nursing situation, the systematic study of nursing calls for a new methodology that recognizes that fact. certainly, we acknowledge that something useful for nursing can be learned through existing methodologies, from both natural and human science traditions. for example, an experimental design can produce information about the effectiveness of a given clinical technique within a specified range of use (e.g., placement of an oral thermometer). such information can be important and useful to the work of the nurse and useful to the client of nursing. it tells us nothing, however, of nursing. in fact, the central tenet underlying measurement in normal science directly contradicts the central tenet of human science: created versus creating. thus, the fullness of the nursing situation is not amenable to study by measurement techniques. yet, aspects of the nursing situation can be abstracted and studied as variables in relation to other variables. this does not, however, yield knowledge of the nursing situation in its fullest. at best, measurement approaches can call attention to an aspect so that it can be considered within the unfolding. phenomenology, on the other hand, offers an example of an orientation and methodology that more closely approximates what is needed in a nursing method of inquiry. phenomenology is an orientation toward inquiry that may be actualized through any one of a number of generic approaches, but is generally understood as the study of lived experience (e.g., van manen, ; oiler, ). when the phenomenon conceptualized for study is representative of the nursing situation, nursing may be known. that is, new nursing knowledge may eventuate. new understanding of the meaning of the shared lived experience of caring between nurse and nursed enhancing personhood can be created. yet, for the purposes of nursing, phenomenology also has its limits. for example, when phenomena which have been abstracted from a nursing situation are selected for study (that is, when phenomena are taken out of context), results of the inquiry cannot generate knowledge of nursing proper. for example, the understanding that comes in developing a description of the essential structure of what it is like for a nurse to be called to nurse informs us about nurses, but not about nursing directly. similarly, an exquisite phenomenological description of what it is like for a person to live grieving is helpful in understanding the person. however, it should not be mistaken for knowledge of nursing, but knowledge which illuminates the study of nursing when taken back to the full context of the nursing situation. further, the various phenomenologies in the literature come from frames of reference that are not nursing (e.g., existential psychology or educational psychology), and thus impose a "silent" borrowed framework when used to study nursing. is this drawing too fine a line? and is it really important to press the issue of nursing knowledge versus knowledge of and for nurses? the answers to these questions are probably found in one's concept of nursing as a field of knowledge (discipline) and a human service (profession). it seems that nursing and nurses have suffered significantly over the years with this dilemma. is it possible to have a sense of self as nurse without a concomitant sense of nursing as a discipline which is more than tacit and to which one is committed? students of nursing and practitioners alike have abundant opportunities to acquire a sense of self as nurse. yet why is it that many programs of nursing education (at all levels) do not convey a sense of nursing as a discipline? the answer may lie in those conducting the programs, who have experienced training for practice and education in disciplines other than nursing and without explicit education in the discipline of nursing. from the perspective of nursing as caring, with its grounding in person as caring and nursing as discipline, the distinctions implied in this question of "does it really matter" are of central importance. nurses in practice, education, and administration continue to address nursing primarily in terms of "what nurses do," (e.g., nursing "interventions") and most nursing research seems to derive from that perspective as well. without a clearly articulated understanding of the focus of the discipline, it has been extremely difficult to organize and structure nursing knowledge in ways that facilitate the development of the discipline. in this book, we have offered a theory, nursing as caring, as one expression of that focus, languaged in terms that communicate the essence of nursing. nursing knowledge is knowledge of nurturing persons living caring and growing in caring within shared lived experiences in which the caring between nurse and nursed enhances personhood. furthering nursing knowledge requires methods that can illuminate the central phenomenon of the discipline. the development of such a methodology is, as we see it, the next major effort to be undertaken in the development of the theory. in this regard, we envision a fully adequate methodology that would include a phenomenological aspect which goes beyond description to a hermeneutical process, within an action research orientation. that is, what seems to be needed is a methodology that would permit the study of nursing meaning as it is being co-created in the lived experience of the nursing situation. supplemental methods could continue to include traditional phenomenological and hermeneutic work with texts describing particular nursing situations. nurses who are interested in developing knowledge of techniques or modes of expressing caring would continue to use traditional methods of formal and human science for these kinds of nursing-related questions. the development of methods of nursing inquiry appropriate to the study of the theory, nursing as caring, is in a formative stage. we understand to a considerable extent the limitations of existing modes of inquiry, and have a growing sense of what will be required of a new methodology. nursing scholars are working to develop methods to illuminate the fullness of nursing. examples of that work which has encouraged our efforts include that by parker ( ), swanson-kauffman ( ), parse ( ), and ray (wallace, ). the work of these scholars demonstrates that the development of nursing ways of inquiry is important and that a search has begun. as we have come to understand the concept of human science, our understanding of nursing has been enriched. like most of our contemporaries in nursing, we were trained in the often-unarticulated assumptions of natural science. and we have traveled the road familiar to many nursing scholars, the road of expertise in objectification and quantification. along that road, we began to notice the trivialization of cherished nursing ideas like presence, touch, relationship, knowing, and caring. resisting the temptation to abandon the journey, we each persevered in a commitment to nursing as something which mattered, something involving intimate, personal, caring relationships. discovering, inventing, and creating a new methodology is an important dream and we are committed to continuing this aspect of theory development. nursing as caring is a transformational model for all arenas. nursing practice, nursing service organization, nursing education, and nursing inquiry require a full understanding of nursing as nurturing persons living caring and growing in caring, and these underlying assumptions: * persons are caring by virtue of their humanness. * persons are caring, moment to moment. * persons are whole or complete in the moment. * personhood is a process of living grounded in caring. * personhood is enhanced through participating in nurturing relationships with caring others. * nursing is both a discipline and profession. with these transformations, the fullness of nursing will be realized and we will grow in our understanding of self and other as caring persons connected in oneness. references boeckh, p. ( ). theory of criticism. in k. mueller-vollmer (ed.), the hermeneutics reader. new york: continuum. droysen, j. ( ). the investigation of origins. in k. mueller-vollmer (ed.). the hermeneutics reader. new york: continuum, pp. - . gadamer, h. ( ). truth and method. new york: crossroad publishers. heidegger, m. ( ). understanding and interpretation. in k. mueller-vollmer (ed.), the hermeneutics reader. new york: continuum, pp. - . macdonald, j. ( ). curriculum and human interests. in w. pinar, curriculum theorizing: the reconceptualists. berkeley: mccutchan publishers. oiler, c. ( ). phenomenology: the method. in p. munhall & c. oiler (eds.), nursing research: a qualitative perspective. norwalk, ct: appleton-century-crofts. parker, m. ( ). living nursing values in nursing practice. paper presented at th annual conference of the southern research association, birmingham, al, february , . parse, r. ( ). parse's research methodology with an illustration of the lived experience of hope. nursing science quarterly, , - . ray, m.a. ( ). the richness of phenomenology: philosophic, theoretic and methodologic concerns. in j. morse (ed.), critical issues in qualitative research. a contemporary dialogue. newbury park, ca: sage, ch. . reeder, f. ( ). hermeneutics. in b. sarter (ed.), paths to knowledge. new york: national league for nursing. swanson-kauffman, k. ( ). a combined qualitative methodology for nursing research. advances in nursing science, ( ), - . van manen, m. ( ). researching lived experience. london, ontario: state university of new york press. wallace, c. ( ). a conspiracy of caring: the meaning of the client's experience of nursing as the promotion of well-being. unpublished master's thesis, college of nursing, florida atlantic university. watson, j. ( ). nursing: human science and human care. a theory of nursing. new york: national league for nursing. [illustration: button] epilogue the theory of nursing as caring was initially presented in its entirety at the south florida nursing theories conference in . the theory was explicated in the original release of nursing as caring: a model for transforming practice in (boykin & schoenhofer, ). as work has progressed to develop the theory for use in nursing practice, research and education, the underlying assumptions introduced in chapter have been affirmed as central to the integrity of the theory. this epilogue highlights ongoing development of the theory by its authors and by other nurses. developmental efforts include clarification of the concept of personhood, expansion of the understanding of enhancing per-sonhood as the general "outcome" of nursing, research innovations, and use of the theory in middle range theory work and in the critical analysis of caring. clarification of the concept of personhood in chapter , personhood was described as a process of living grounded in caring. in an effort to clarify the meaning of "a process" in the context of the theory of nursing as caring, we explained that personhood, understood as living grounded in caring, is processual--ongoing, experienced moment to moment, evolutionary, transformative--rather than a generalized sequence of steps or operations. in subsequent publications, personhood was described as "living grounded in caring," eliminating the problematic use of the term "process" entirely (schoenhofer & boykin, a; boykin & schoenhofer, ). research development of the foundational concepts of person as caring and personhood nursing as caring guides nurses to enter into the world of the other and allows them to come to know the nursed as living caring uniquely in situation. in consulting with nurses using nursing as caring as their framework for practice, we found that nurses could easily recognize expressions of caring when caring was lived in ways familiar to their own lifeworlds. however, in nursing situations where personal ways of caring were outside the experience of the nurse, there seemed to be difficulties in knowing and thus affirming the nursed as person uniquely living caring in the moment. without this situated knowing, we saw that nurses tended to lose the focus of recognizing the other as living caring uniquely in the moment, and instead, to concentrate on ways in which persons "were not living caring" and "should grow in caring." this tendency to return to a normative practice framework in difficult times is easily understood as nurses struggle to transcend a familiar paradigm characterized by terms such as "nursing process," "nursing diagnosis," "nursing intervention" and to evolve toward what has been called a simultaneity paradigm (parse, ). because knowing the other as caring is the basic act of nursing, it became clear to us that knowledge expansion would be helpful in enhancing nurses' ability to recognize uniquely personal ways their patients live the value of caring. schoenhofer conducted a series of studies over several years to develop knowledge of personal lived meaning of everyday caring. in one unpublished study, adolescents shared stories of personal caring. their stories were found to center around the theme of "helping out." adolescents described everyday caring in terms such as "cheering up someone you love," "helping another get what they need," "work as caring," "caring by physical presence." the stories illustrated situations where caring was expressed as "helping out when you don't really want to, but doing it anyway," "helping without being asked," "filling in where caring is missing." one teenage boy told of caring for a former girlfriend who was angry about their breakup; he made deliberate efforts to remain active as a friend, as a way to help the girl deal with the loss of their romantic relationship. he characterized his caring as "keeping on showing care even though it doesn't seem to change things." in another similar study, th grade students told stories of caring in which they acted as advocates for other children and offered help to others, both adults and children, who were perceived as less fortunate and in need of care (schoenhofer, bingham & hutchins, ). adults, too, have unique and personal ways of living their everyday caring. one father related an example of caring for his young daughter by restricting her activities because of poor school performance, and then engaging in a dialogue with her that resulted in a compromise. the father saw willingness to discipline as an act of caring and felt that his willingness to listen to the child's perspective was also part of his caring (schoenhofer, bingham & hutchins, ). several adults whose parents had become disabled told stories of caring for parents in ways that preserved cherished role relationships. these adults understood that their caring required extra effort to avoid infantalization of the parent but felt that without that extra effort, attention would be given to certain needs but adequate caring would not be given. research into everyday caring was conducted in a group discussion format, with persons invited to relate a story that illustrated how they lived their caring in everyday situations. the ease with which these research participants understood what was being asked of them, their willingness to respond and the clarity of the exemplars they shared have the potential to inform nursing practice. when nurse colleagues learned of this research effort, they often expressed doubt that people could and would describe their everyday caring ways. based on the experience of the researchers and research participants in this series of studies, however, it became clear that persons do understand their unique ways of caring, and do recognize the importance of sharing that understanding. nurses committed to practice guided by the tenets of nursing as caring can and should incorporate direct invitation as part of their coming to know other as caring person, a number of important benefits are possible with a direct approach to knowing the other as caring. one benefit is that as the nurse raises the issue of caring, patients are helped to understand that caring is of immediate importance to nurses, thus clarifying the service and value of nursing among the health disciplines. a second benefit is that as nurses address caring directly with their patients, nurses themselves gain affirmation of nursing as a caring service and of themselves as persons committed to caring. however, the most immediate benefit of a direct approach to caring is the opening of a line of communication that clearly establishes the "caring between," that space, that relationship within which and through which all that is important in nursing occurs. the patient is given the opportunity to recognize self as caring person and to join in mutual affirmation and celebration with the nurse. nurses who are reluctant to engage patients in dialogues about caring ways may think the topic is "too intimate." it is true that caring is intimate and personal, but caring is also very visible, just as many of the topics introduced in the nursing situation are personal and intimate and have visible referents. as nurses have the courage to raise the topic of caring, the central importance of caring in human living can become not only recognized but openly and publicly valued. research development of nursing outcomes-values experienced in the nursing situation another research thread has focused on the development of an approach to identifying and languaging outcomes of nursing guided by the theory of nursing as caring (boykin & schoenhofer, ; schoenhofer & boykin, a, b). within the context of the theory, the idea of outcomes has been reconceptualized as "values experienced in the nursing situation." several case studies illuminated a dialogical form of praxis involving nurse, patient and researcher that revealed values experienced by patients and their nurses. values experienced by families, health care administrators and systems were also uncovered as the caring created in the nursing situation was found to resonate beyond the immediate nurse-patient relationship. this line of research has demonstrated that while traditional economic valuation can be calculated, the value of caring in nursing can and must be more clearly explicated in human terms. for example, one case study of home health nursing found that the economic value of six nursing visits produced a health care cost savings of $ , , primarily by obviating the necessity of trips to the emergency department of the local hospital. through this unique research approach, the human value of the six visits was identified and languaged in terms that clearly demonstrate the direct, unmediated worth of nursing care--to the one nursed, the family, the nurse and the larger circle of health care systems. the patient and family gained the important value of confidence through the caring of the home health nurse; with the nurse's commitment to caring, they gained faith in themselves, their ability to deal with new health-related situations as they arose, faith that they wouldn't be left alone, faith that they were known as persons valuable in their own right and worthy of care. this is the value of nursing, the reason nursing exists as a distinguishable social and human service. nurses can learn to assert the human value of nursing, and in fact, nurses must accept the responsibility for bringing the human value of care to the forefront. re-establishing the primary position of care in the health care arena depends on nurses speaking out in clearly human terms about the meaning and value of care, using the language of caring knowledgably and without apology. in may, , boykin launched a funded study to examine the potential of the theory of nursing as caring to enhance the achievement of quality outcomes in acute care settings. this two-year demonstration project and evaluation study involves specifying quality indicators and targeting benchmarks prior to introducing the theory as the nursing practice framework in the acute care division of a community hospital. on-site guidance and consultation in the use of the theory will be available during the course of the project. post-program evaluation will focus on quality indicators and benchmarks relating to patient and staff satisfaction, family and community support, and cost-benefit care ratios. the theory of nursing as caring as a conceptual frame for middle-range theories a theory that describes or explains a limited range of situations. locsin ( ) developed a model of the harmonious relation between technology and caring in nursing. further development of the model led to a theory of technological competence as caring in critical care nursing (locsin, ). the mediating factors between application of technology and caring in nursing are posited as intentionality and authentic presence. the underlying theoretical framework draws on the theory of nursing as caring, and particularly the focus of nursing as knowing and thus nurturing the other as caring person. the intention to know the other as caring person is actualized through direct knowing as well as through the medium of technologically produced data. the intention to care, to nurture the other as caring, is expressed in interpersonal ways as well as in technological competence. dunphy ( ) drew on aspects of the theory of nursing as caring, particularly the idea of knowing the other as caring person, in the development of a model for advanced practice nursing, "the circle of caring." dunphy was concerned with clarifying the disciplinary identify of advanced practice nursing as nursing. in an effort to transcend perspectives of advanced practice nursing based on the traditional reductionist medical science and nursing process models, processes of care are superimposed on a traditional medical model (dunphy, ). the circle of care "incorporates individual strengths of both nursing and medicine but reformulates them in a new model of care... rooted in the lived experience of the patient" (p. ). caring quality indicators suffuse the entire model, and include courage, authentic presence, advocacy, knowing, commitment and patience. elements formerly termed diagnosis and treatment are termed caring processes in the new model, in an attempt to ground advanced practice in nursing values. the core component of the model, caring processes, focuses on ways of knowing the person as caring and of truly being with the person in advanced practice nursing situations. it is this core that provides the crucial link of caring as the central focus of both traditional nursing and advanced practice nursing. critical analysis of the theory of nursing as caring there is evidence that the theory of nursing as caring has entered the mainstream of nursing thought. nursing as caring is included in several collected and/or edited works on nursing theories (george, ; parker, ; parker, ). in george's ( ) compendium of general nursing theories, nursing as caring is described and the structures of nursing process and the metaparadigm concepts of fawcett are used as a framework for analysis and evaluation. parker's books, patterns of nursing theories in practice ( ) and nursing theories and nursing practice ( ) are collections of original chapters authored by the various nurse theorists and by nurses using the particular theory in practice. nursing as caring is represented in both these books by original chapters authored by the theory's originators (schoenhofer & boykin, ; boykin & schoenhofer, ) as well as by chapters written by nurses describing their practice which is guided by the theory (kearney &yeager, ; linden, ). nursing as caring was one of four caring theories included in a comparative analysis reported by mccance, mckenna and boore ( ). that analysis was based on a number of factors, including origin, scope and key concepts of the theory, definition of caring, description of nursing, the goal or outcome of nursing from the perspective of the theory, and simplicity of the internal structure. findings of the analysis were developed in terms of utility of the theory in practice. smith ( ) analyzed concepts from the literature on caring in nursing in an effort to uncover points of congruence between that literature and the theoretical perspective of the science of unitary human beings. the theory of nursing as caring figured prominently in smith's concept clarification, contributing to four of the five synthesized constitutive meanings of caring: manifesting intentions, appreciating pattern, attuning to dynamic flow and inviting creative emergence (smith, ). research method development in chapter , theory development and research, we envisioned an approach that "would include a phenomenological aspect which goes beyond description to an hermeneutical process, within an action research orientation" (boykin & schoenhofer, , p. ). two research approaches have been developed within the context of studying nursing as caring, one focusing on discovering the lived meaning of everyday caring and the second directed toward understanding the value experienced in nursing situations. there is relatively little literature that deliberately sets out to describe the multitude of ways of human caring. however, most if not all human text does reflect uniquely personal ways of caring, and can profitably be studied for this purpose. in an effort to provide a knowledge base of the variety of human caring ways, one of the authors (schoenhofer) innovated a group phenomenology approach in which research participants not only generated data in group settings, but also led the synthesis of meaning (schoenhofer, bingham, & hutchins, ). the group approach to data generation was chosen for several reasons--one was efficiency, but the primary reason was a belief in the synergistic potential of the group process experience. the group approach to data synthesis was added to the design based on the assumption that persons living the phenomenon being studied and generating the data may be most well qualified to intuit meaning across examples. the series of studies of everyday caring may best be understood as general foundational human science, rather than as nursing science per se. results of the studies produced knowledge that has potential to enlighten nursing practice, rather than producing direct knowledge of nursing practice. while initiated for research purposes, the group phenomenology approach became a form of nursing praxis. early in the project, groups spontaneously shared a sense of pleasure and gratitude for the experience of celebrating themselves and each other as caring persons. this opportunity for reflection was then added as closure for the subsequent groups as it was recognized by the primary researchers that the tenets of nursing as caring were being lived: persons were known, acknowledged, affirmed and celebrated as caring; per-sonhood was enhanced as group members recapitulated, clarified and reaffirmed the meaning and value of caring in their lives; caring between nurse (researchers) and nursed in the nursing (research) situation was created and persons were nurtured in their uniquely personal ways of caring. a second research approach was designed to study values experienced in nursing situations (schoenhofer & boykin, a; b). the design of this approach was based on several considerations: ) the tenet that all that can be known of nursing is known through the nursing situation, the shared lived experience of caring between nurse and nursed; and, ) the blurred lines between research and practice, between roles of researcher, practitioner and even patient. a mode of inquiry into outcomes of caring in nursing, from the perspective of nursing as caring, must necessarily be centered within the nursing situation. in earlier phases of this research, only the nurse participated in the research dialogue (boykin & schoenhofer, ). while this approach was fruitful, two important qualities were missing: ) the synergism that brought a wealth of rich data when both nurse and nursed were present; and, ) the intersubjective confirmation provided by having both the nurse and the nursed as research participants. once again, the mutuality of the dialogue about the value of caring experienced went beyond simple data production for research purposes. the dialogue itself was an extension of the nursing relationship and the caring between nurse and nursed, with the research nurse now included in the unfolding nursing situation. [illustration: button] conclusion this epilogue has been written to bring the reader up to date on the development of the theory of nursing as caring. developmental efforts projected in chapter are still needed, and efforts in progress hold promise for further development. as the cadre of nurses interested in working within the theory grows, development will accelerate, in both projected and novel directions. anne boykin, phd, rn professor and dean college of nursing florida atlantic university boca raton, florida october, savina o. schoenhofer, phd, rn professor of graduate nursing alcorn state university natchez, mississippi references boykin, a., & schoenhofer, s. . ( ). nursing as caring: a model for transforming practice. new york: national league for nursing press. boykin, a., & schoenhofer, s. . ( ). nursing as caring: an overview of a general theory of nursing. in parker. m. e., ed., nursing theories and nursing practice. philadelphia: f. a. davis co. boykin, a., & schoenhofer, s. . ( ). reframing nursing outcomes. advanced practice nursing quarterly, ( ), - . dunphy, l. h. ( ). the circle of caring: a transformative model of advanced practice nursing. th research conference of the international association for human caring, philadelphia, pa. george, j. b. ( ). nursing theories: the base for nursing practice. ( th ed.). norwalk: ct: appleton & lange. kearney, c. & yeager, v. ( ). practical applications of nursing as caring theory. in parker, m. e., ed. patterns of nursing theories in practice. new york: national league for nursing press, ch. . linden, d. ( ). application of nursing as caring in practice. in parker, m. e., ed., nursing theories and nursing practice. philadelphia: f. a. davis co., . locsin, r. c. ( ). machine technologies and caring in nursing. image, , - . locsin, r. c. ( ). technological competence as caring in critical care nursing. holistic nursing practice, ( ), - . mccance, t. v., mckenna, h. p., & boore, j. r. p ( ). caring: theoretical perspectives of relevance to nursing. journal of advanced nursing, , - . parker, m. e. (ed.). ( ). nursing theories and nursing practice. philadelphia: f. a. davis co. parker, m. e. (ed.). ( ). patterns of nursing theories in practice. new york: national league for nursing. parse, r. r. ( ). nursing science: major paradigms, theories and critiques. philadelphia: saunders. schoenhofer, s. ., bingham, v., & hutchins, g. c. ( ). giving of oneself on an-other's behalf: the phenomenology of everyday caring. international journal for human caring, ( ), - . schoenhofer, s. ., & boykin, a. ( ). nursing as caring: issues for practice. in parker, m. e., (ed). patterns of nursing theories in practice. new york: national league for publications, pp. - . schoenhofer, s. ., & boykin, a. ( a). the value of caring experienced in nursing. international journal for human caring, ( ), - . schoenhofer, s. ., & boykin, a. ( b). discovering the value of nursing in high tech environments: outcomes revisited. holistic nursing practice, ( ), - . smith, m. c. ( ). caring and the science of unitary human beings. advances in nursing science, ( ), - . [illustration: button] index adaptation model (roy), , administration, nursing education, , - administration, nursing service, - advanced practice, aesthetic knowing, , , , , , , , , , aesthetic project, allen, d.g. "nursing research and social control: alternative models of science that emphasize understanding and emancipation," "the social policy statement: a reappraisal," "the american nurses' association position statement on nursing and social policy: philosophical and ethical dimensions" (silva), american nursing association nursing: a social policy statement, analysis and evaluation of conceptual models of nursing (fawcett), andrews, h. the roy adaptation model: the definitive statement, - "application of nursing as caring in practice" (linden), the art of administration (tead), authentic presence, - , - , , avant, k. strategies for theory construction in nursing, "ave maria and therapeutic touch for david" (stobie), - "the behavioral system model of nursing" johnson), - benner, p. the primacy of caring: stress and coping in health and illness, bingham, v. "giving of oneself on another's behalf: the phenomenology of everyday caring," , boeckh, p. theory of criticism, bohm, d. "on dialogue," boore, j. r. p. "caring: theoretical perspectives of relevance to nursing," boykin, a. "caring in nursing: analysis of extant theory," , , - "creating a caring environment: moral obligations in role of dean," "discovering the value of nursing in high tech environments," , "nursing as caring: issues for practice," nursing as caring: a model for transforming practice, , nursing as caring: an overview of a general theory of nursing, , "reframing nursing outcomes," , "story as link between nursing practice, ontology, epistemology," , , , "the value of caring experienced in nursing," , , brownell, j. the curriculum and the disciplines of knowledge, xiv, budget decisions, calls for nursing, , , administrator, nursing, - dance of caring persons, - and education, nursing, , nursing situation, , , - , , , - study of, caring and technology, "caring and the science of unitary human beings" (smith), caring and advanced practice, caring theories compared, "caring between" phenomenon, "caring for life and death: nursing in a hospital-based hospice" (samarel), "caring from a human science perspective" (parse), "caring in nursing: analysis of extant theory" (boykin & schoenhofer), , , - "caring in the instance of unexpected early pregnancy loss" (swanson-kauffman), caring in the moment, caring ingredients (mayeroff), - , , , , caring: the human mode of being, implications for nursing (roach), , "caring: theoretical perspectives of relevance to nursing" (mccance, mckenna, and boore), carper, b. "fundamental patterns of knowing in nursing," - , , - carr, s. "intensive care," - , cassarrea, k. "improving service through patient surveys in a multihospital organization," chinn, p. theory and nursing, "the circle of caring: a transformatic model of advanced practice nursing" (dunphy), "a combined qualitative methodology for nursing research" (swanson-kauffman), , concept formalization in nursing: process and product (nursing development conference group), , "connectedness: a concept for nursing" (kronk), - "connections" (maxwell), - cooper, m.c. "covenantal relationships: grounding for the nursing ethic," cost containment, covenantal relationship, , "covenantal relationships: grounding for the nursing ethic" (cooper), "creating a caring environment: moral obligations in role of dean" (boykin), "a critique of the ana social policy statement population and environment focused nursing" (white), "curriculum and human interests" (macdonald), the curriculum and the disciplines of knowledge (king and brownell), dance of caring persons, - illus. and faculty selection, and nursing education, - , deceased patient, , "deconstructing the dogma in nursing knowledge and practice: (rodgers), deviant/evil patient, , dialogue, use of in education, - difficult to care situation, "the dilemma of nursing: current quandaries and lack of direction" (packard and polifroni), discipline, nursing as, - and education, nursing situation, - and phenomenology, - and theory development, - "discovering the value of nursing in high tech environments" (boykin and schoenhofer), , droysen, j. "the investigation of origins," duffy, j. "the impact of nurse caring on patient outcomes," dunphy, l. h. "the circle of caring: a transformatic model of advanced practice nursing," the dynamic nurse-patient relationship (orlando), - education, nursing, , - administration, , - dance of caring persons, - dialogue, - faculty selection, knowing, patterns of, - and nursing situation, empathic paradigm, empirical knowing, , , , , , essay examination, "the essential structure of a caring interaction: doing phenomenology" (riemen), ethical knowing, , , , , , everyday caring, , "existential advocacy: philosophical foundations of nursing" (gadow), faculty, selection of, fawcett, t. analysis and evaluation of conceptual models of nursing, flexner, a. medical education in the united states and canada, "fundamental patterns of knowing in nursing" (carper), , - gadamer, h. truth and method, gadow, s. "existential advocacy: philosophical foundations of nursing," "touch and technology: two paradigms of patient care," , , george, j. b. nursing theories: the base for nursing practice, "giving of oneself on another's behalf: the phenomenology of everyday caring" (schoenhofer, bingham, and hutchins), , guralnik, d. webster's new world dictionary of the american language, "healing-hiv+" (wheeler), health services discussion, nursing's contribution to, heidegger, m. "understanding and interpretation," nelson's adaptation level theory, hermeneutic circle, , "hermeneutics" (reeder), hologram and view on relationships, home nursing, "honestly" (little), - the human act of caring (roach), human care, theory of (watson), human science, nursing as, , - , - humanistic nursing (paterson & zderad), hutchins, g. c. "giving of oneself on another's behalf: the phenomenology of everyday caring," , "the impact of nurse caring on patient outcomes" (duffy), "improving service through patient surveys in a multihospital organization" (cassarrea, mills, & plant), "intensive care" (carr), - , intentionality, "the investigation of origins" (droysen), jacobs, m. theory and nursing, johnson, d.e. "the behavioral system model of nursing", , journaling, kearney, c. "practical applications of nursing as caring theory," king, a., ix the curriculum and the disciplines of knowledge, knowing aesthetic, , , , , , as caring ingredient, - , empirical, , , , , , four patterns of, , , - personal, , - , - , - , - , knowlden, v. "the meaning of caring in the nursing role," knowledge, nursing, , , - , - kronk, p. "connectedness: a concept for nursing," - languages of the brain: experimental paradoxes and principles (pibram), "last rights" (yelland-marino), leininger, m.m., xiv "leininger's theory of nursing: cultural care diversity and universality," index little, d. "honesty," - linden, d. "application of nursing as caring in practice," living caring, - , - , , , , , "living nursing values in nursing practice" (parker), locsin, r. c. "machine technologies and caring in nursing," "technological competence as caring in critical care nursing," "love, beauty and truth: fundamental nursing values" (schoenhofer), macdonald, j. "curriculum and human interests," "machine technologies and caring in nursing" (locsin), maxwell, g. "connections," - mayeroff, m., ix on caring, - , - , , , , mccance, t. v. "caring: theoretical perspectives of relevance to nursing," mckenna, h. p. "caring: theoretical perspectives of relevance to nursing," "the meaning of caring in the nursing role" (knowlden), the meaning of persons (tournier), medical education in the united states and canada (flexner), meleis, a. theoretical nursing: development and progress, mentally disabled child, middle range theory, - mills, j. "improving service through patient surveys in a multihospital organization," neuman, b. the neuman systems model, "noncaring and caring in the clinical setting: patient's descriptions" (riemen), nurse administrator, - budget decisions, and calls for nursing, , nursing situation, - relationship to direct care, - nursed as caring person, nursing as caring: a model for transforming practice (boykin and schoenhofer), , nursing as caring: an overview of a general theory of nursing (boykin and schoenhofer), , "nursing as caring: issues for practice" (boykin and schoenhofer), nursing: a social policy statement (american nurses association), nursing as caring as stabilizer of organization, - discipline and profession, nursing as, - educational program grounded in, ideas related to, - ideologies/cognitive frameworks not congruent with, nurse administrator decisions, persons as caring, perspective of, - transformational model, theory, ix-x, - nursing development conference group, ix concept formalization in nursing: process and product, - nursing diagnosis movement, - , , nursing: human science and human care. a theory of nursing (watson), , , "nursing on the caring edge; metaphorical vignettes" (watson), "nursing process" (orlando), - , "nursing research and social control: alternative models of science that emphasize understanding and emancipation (allen), "nursing science, major paradigms, theories and critiques" (parse), nursing situation, - , , - , and administration, nursing, - education, nursing, - persons with altered levels of consciousness, - re-presentation of via art forms, shared lived experience, , - , , study of, - theory development, nursing theories: the base for nursing practice (george), "nursing theories and nursing practice (parker), oiler, c. "phenomenology: the method," on caring (mayeroff), - , - , , , , "on dialogue" (bohm), orem, d.e. nursing: concepts of practice, , self-care deficit theory of nursing, , organization hierarchical model of, - stabilizer, nursing as caring as, - orlando, l the dynamic nurse-patient relationship, - nursing process approach, - , outcomes of caring, - packard, s.a. "the dilemma of nursing science: current quandaries and lack of direction," parenthood, nursing profession as, parker, m. "living nursing values in nursing practice," nursing theories and nursing practice, patterns of nursing theories in practice, parse, r. "caring from a human science perspective," "nursing science, major paradigms, theories and critiques," "parse's research methodology with an illustration of the lived experience of hope", parson's theory of social system analysis, paterson, j., ix humanistic nursing, patient satisfaction, patterns of nursing theories in practice (parker), person as caring, - , - , , - discipline and profession, nursing as, - person as complete/whole, , - personal knowing, , , , - personhood, , , , , , , phenix, p., ix realms of meaning, , , , phenomenology, - phenomenology: the method (oiler), philanthropic paradigm, , , , plant, m. "improving service through patient surveys in a multihospital organization," polifroni, e.c. "the dilemma of nursing science: current quandaries and lack of direction," post-anesthesia patient, postmortem care, , "practical applications of nursing as caring theory" (kearney and yeager), practice of nursing, - communicating caring in, and interface with health care system, pribram, k.h. languages of the brain: experimental paradoxes and principles, in neuropsychology, the primacy of caring: stress and coping in health and illness (benner & wrubel), problem oriented medical records, processual, nursing as, profession, nursing as, - , - , , , as caring, - contribution to health policy planning, - covenantal relationships, and nursing inquiry, social contract, ray, m.a., xiv "the richness of phenomenology: phenomenologic-hermeneutic approaches," ix, , realms of meaning (phenix), reason and commitment (trigg), reeder, e "hermeneutics," "reframing nursing outcomes," (boykin and schoenhofer), , index re-presentation of nursing situation, research methods, - researching lived experience (van manen), , "the richness of phenomenology: phenomenologic-hermeneutic approaches" (ray), riemen, d. "the essential structure of a caring interaction: doing phenomenology," "noncaring an caring in the clinical setting: patients' descriptions," roach, s., ix caring: the human mode of being, implications for nursing, , the human act of caring, rodgers, b.l. "deconstructing the dogma in nursing knowledge and practice," roy adaptation model, roy, c. the roy adaptation model: the definitive statement, , samarel, n. "caring for life and death: nursing in a hospital-based hospice," schoenhofer, s. "caring in nursing: analysis of extant theory," , , - "discovering the value of nursing in high tech environments," , "giving of oneself on another's behalf: the phenomenology of everyday caring," , "love, beauty and truth: fundamental nursing values," "nursing as caring; issues for practice," nursing as caring: a model for transforming practice, , nursing as caring: an overview of a general theory of nursing, , "reframing nursing outcomes," , research data, unpublished, "story as link between nursing practice, ontology, epistemology," , , , "the value of caring experienced in nursing," , , science, movement toward, self as caring person, - , - , , , , self-care deficit theory of nursing (orem), , shared lived experience, - silva, m.c. "the american nurses' association position statement on nursing, and social policy: philosophical and ethical dimensions," smith, m. c. "caring and the science of unitary human beings," social contract, , "the social policy statement: a reappraisal" (allen), stobie, m. "ave maria and therapeutic touch for david," - "story as link between nursing practice, ontology, epistemology" (boykin & schoenhofer), , , , story, use of, difference from nursing case report, in education, , strategies for theory construction in nursing (walker & avant), swanson-kauffman, k. "a combined qualitative methodology for nursing research," , "caring in the instance of unexpected early pregnancy loss," tead, . the art of administration, "technological competence as caring in critical care nursing" (locsin), technology, technology movement, theoretical nursing: development and progress (meleis), theory and nursing (chinn and jacobs), theory development and research, nursing as caring, vii--viii, - levels of, middle range, - model development, history of, phenomenology orientation, "theory of criticism" (boeckh), theory of nursing as caring, - time allocation, - "touch and technology: two paradigms of patient care" (gadow), , , tournier, p. the meaning of persons, trigg, r. reason and commitment, truth and method (gadamer), unconscious patient, , "understanding and interpretation" (heidegger), "untraining" of nurses, - "value of caring experienced in nursing, the" (boykin and schoenhofer), , , van manen, m. researching lived experience, , von bertalanffy's general systems theory, walker, l. strategies for theory construction in nursing, watson, j., ix nursing: human science and human care. a theory of nursing, , , "nursing on the caring edge: metaphorical vignettes," webster's new world dictionary of the american language (guralnik), wheeler, l. "healing-h v+ ," white, c.m. "a critique of the ana social policy statement ... population and environment focused nursing," winland-brown, j. unpublished research data, wrubel, j. the primacy of caring: stress and coping in health and illness, yeager, v. "practical applications of nursing as caring theory," yelland-marino, t. "last rights," zderad, l., ix humanistic nursing, nursing as caring a model for transforming practice anne boykin, savina o. schoenhofer caring is one of the first words that comes to mind when talking about the practice of nursing. caring is an essential value in the personal and professional lives of nurses. however, the formal recognition of caring in nursing as an area of study is relatively new. nursing as caring sets forth a different order of nursing theory. this new nursing theory is personal, not abstract. the focus of the nursing as caring theory is not toward an end product such as health or wellness; it is about a unique way of nurses living caring in the world. this theory provides a view that can be lived in all nursing situations and can be practiced alone or in combination with other theories. this is perhaps the most basic, bedrock, and therefore radical, of nursing theories and is essential to all that is truly nursing. experience courtesy of the digital library@villanova university (http://digital.library.villanova.edu/)) books by margaret vandercook the ranch girls series the ranch girls at rainbow lodge the ranch girls' pot of gold the ranch girls at boarding school the ranch girls in europe the ranch girls at home again the ranch girls and their great adventure the red cross girls series the red cross girls in the british trenches the red cross girls on the french firing line the red cross girls in belgium the red cross girls with the russian army the red cross girls with the italian army the red cross girls under the stars and stripes stories about camp fire girls the camp fire girls at sunrise hill the camp fire girls amid the snows the camp fire girls in the outside world the camp fire girls across the sea the camp fire girls' careers the camp fire girls in after years the camp fire girls in the desert the camp fire girls at the end of the trail the red cross girls in belgium [illustration: "lieutenant hume!" (_see page ._)] the red cross girls in belgium by margaret vandercook author of "the ranch girls series," "stories about camp fire girls series," etc. illustrated the john c. winston company philadelphia copyright, , by the john c. winston co. contents chapter page i. under other skies ii. a modern knight errant iii. a secret mission iv. plans for the future v. st. gudula vi. the locked door vii. a triangle viii. a prison and a prisoner ix. a second acquaintance x. a discussion, not an argument xi. monsieur bebÉ xii. the ghost xiii. an arrest xiv. a month later xv. powerless xvi. louvain xvii. "sisters under the skin" xviii. difficulties xix. en route xx. noel the red cross girls in belgium chapter i _under other skies_ after six months of nursing in the british trenches the four american red cross girls were inspired to offer their services to the french soldiers. an autumn and a winter they spent together in southern france, keeping house in the little french "farmhouse with the blue front door." here the girls were so interested and so happy that for a little time they almost forgot the tragedies near at hand. during the first months there had come a lull in the fighting along the borders of alsace-lorraine, where the american girls were now stationed. so they had opportunity for enjoying the fragrant woods, "the pool of melisande" and the romantic atmosphere of the french country. their farmhouse was close upon the borders of an old chateau and belonged to its owner, the countess castaigne. after a slight misunderstanding a friendship develops between the old countess and three out of the four american girls. and here in the dignified old louis xiv drawing room they meet for the second time young captain henri castaigne, whom in paris they had seen decorated with the cross of the legion of honor. but between eugenia peabody, the new england girl who confesses herself to have been born an "old maid," and the gifted young frenchman, there seems to be an immediate antagonism. nevertheless, when the germans finally surprise the french by an unexpected attack during the french retreat, it is eugenia who alone rescued and cared for the wounded young officer. the other girls, with the countess amélie, join the french army in their new position. later, when the french retake their old trenches, they return to the former neighborhood. but for weeks eugenia has devoted herself to concealing captain castaigne from the germans and to nursing him back to health. naturally at the end of this time a change in their relations has taken place. captain castaigne has developed a deep affection for eugenia. but it is difficult to understand her attitude toward him. in any case, she makes up her mind that it is wiser for the four american red cross girls again to change their field of labor. so at the close of the story of "the red cross girls on the french firing line," they have decided to leave for belgium. "we simply must get into brussels some time this afternoon," barbara meade declared. she was wearing her nurse's uniform and her manner and expression were more than ordinarily professional. about ten days before the four american red cross girls had arrived in belgium. they were now seated on piles of loose brick and stone looking out toward a brilliant sunset. before them the land lay bleak and desolate, while a half-burned house formed their background. nevertheless, as it was early summer time, tiny blades of green were peeping up from the dry stubble. on the single apple tree that had been left standing in a once comfortable orchard, a few apples at the top were slowly ripening. except for this there were few other signs of summer's fulfilment. in response to barbara's speech eugenia peabody now shook her head with her usual decision. "sorry, but i can't go with you," she answered abruptly. "i have something more important to do. tell them at the headquarters i'll try and come another day." then without glancing at any one, eugenia rose and stalked away. she walked toward a small one-room cottage at some distance behind the ruined house. there she stood with her hands clasped before her. the place was utterly still and deserted. yet it was difficult to tell whether eugenia was listening for some unusual sound, or whether she was thinking upon a subject hundreds of miles from the present scene. the girls were living in a big house a few miles outside of brussels. this was only a temporary arrangement, as they had not yet received their orders for work from the belgian red cross headquarters. barbara at this moment dug her shoe reflectively into the soft earth, in the meanwhile staring after her friend. "do you know, girls, eugenia peabody has become a mystery to me lately? when we started off on our expedition to europe together, i thought i understood her character better than either of you. now i simply don't see through her at all!" barbara frowned meditatively. "here she has been an heiress all this time, much richer even than mildred thornton, when we believed her as poor as a church mouse! but how could any human being have suspected eugenia of riches when she wore such dreadful clothes?" so plaintively did barbara conclude her speech that her two companions laughed. since arriving in tragic little belgium they had not been able to laugh frequently. but being only girls they welcomed every opportunity. nona nodded agreement with her friend's point of view. the next moment she turned from one to the other of them. her expression had grown more serious. "we were hurt with eugenia for not taking us into her confidence sooner, weren't we?" she remarked, not so much in the manner of asking a question as of making a statement. if there had not been a rose-colored light on her face from the sunset nona would seem to have flushed at this instant. "i was wounded," she went on, "even though eugenia explained that she had not meant to deceive us. she grew up very poor and when an old bachelor uncle left her a fortune she never learned how to spend her money because of her frugal new england training." "well, she is learning to spend it on other people now," mildred thornton interrupted. "it seems tremendously kind for eugenia to have brought the little french girl, nicolete, over to belgium with us. she really shocks eugenia every five minutes in the day, but i suppose gene is trying to turn the child into a puritan. really, she had no reason in the world for being interested in nicolete except that she was helpful when captain castaigne was ill. then i presume eugenia felt she might get into trouble with no one to look after her, as she would spend her time amusing the french soldiers." "mildred!" barbara meade whispered, "do be more careful. you know we promised to say nothing of nicolete's french origin. she would never have been allowed to come into belgium if her nationality had been known. and eugenia is dreadfully nervous for fear the child may be suspected as a spy. no one is too young to escape suspicion these days!" barbara made this speech in hushed tones all the time looking carefully about her. the countryside was for the time being deserted, but at any moment a group of german soldiers might pass by on the way to their barracks. a well-traveled road ran along in front of the place where the red cross girls were seated. about an hour before they had come out together for a walk before dinner and were now resting on their journey back to their new belgian headquarters. at this moment nona davis got up and stood facing her other two friends. "i have something to tell you," she began, "and i expect i had best not put it off any longer. i had it in mind when i spoke of eugenia's secrecy, for you see we have all grown so intimate that we are almost like sisters. i--i too have a confession to make. i tried to tell you when we were crossing on the steamer together. then it seemed to me i had no right to think you would be interested, and probably you won't be interested now." barbara was leaning her rounded chin on her hand. mildred's lips were parted and her breath coming a little quicker by reason of her interest. for she and barbara both recalled nona davis' previous hesitation when talking of herself. they only knew a few facts concerning her history. she had been brought up by her father, an old southern soldier, in the city of charleston, south carolina. she had led a very lonely, secluded life. these were all their facts. but since nona was still hesitating barbara smiled at her, wrinkling up her small nose in the absurd fashion she had when particularly in earnest. "go on, nona, tell us at once. are you a princess in disguise? i am quite prepared to believe it. to tell you the honest truth, it would not surprise me half so much as eugenia's turning into an heiress. alas, that i am what i am, a maid without a mystery!" however, nona was not in the humor to be diverted by her friend's nonsense. "i am sorry my story is not in the least like that. so i am afraid it won't be of interest to you. perhaps i am foolish to speak of this, since i have never, never talked of it to any one before." nona's brown eyes were clear and straightforward, although her chin quivered sensitively. "i know nothing about my mother," she went on speaking quickly, now that she had made up her mind to the confidence. "of course, i remember her when i was a very little girl in our old house in charleston. but after she went away my father would never talk of her nor answer any of my questions. i do know, however, that she was a great deal younger than he, and i think she was french and came from new orleans. there must have been something strange about my mother or her family; i never could decide and no one would ever tell me. even after i grew up and asked questions of my father's old friends there was always the same silence. this was one of the reasons why i made up my mind to come away from charleston," nona finished quietly. she had not been tragic or dramatic in the telling of her story, and yet neither of her two girl friends knew exactly what to answer. but since the silence must somehow be broken, mildred thornton murmured, "how very odd; perhaps you are mistaken, nona!" then she realized that she had made an absurd speech. barbara was even more visibly embarrassed. "possibly your mother was a princess or something!" she ejaculated vaguely. "i always insisted that you were one of the most aristocratic persons i ever knew, both in your appearance and manner, nona," her friend continued, desiring to be comforting and yet appreciating that her remarks were also rather ridiculous. nona, however, was not to be turned aside in her confession. "i have only spoken of this because i wanted you girls to know the facts in my life that are important. of course, i realize this problem of mine cannot mean a great deal to you. but it has puzzled me all my life. you see, i don't even know whether my mother is living or dead. i have supposed that she was dead, and my father always talked as if she were; but i really am not sure of even that." nona then extended a hand to each of her friends. "please let us never speak of this again," she asked. "of course, i mean to tell eugenia, for it was because we were hurt by her lack of confidence in us that i nerved myself for my confession." nona then sat down again as if the entire subject were closed forever. so, although the other girls had dozens of questions at the tips of their tongues, they remained politely silent. in order to conceal her embarrassment mildred thornton glanced around to try to find eugenia. she discovered that the older girl had at last been disturbed from her reverie. indeed, she had risen and was walking toward the road. for a noise with which they had grown familiar in the past fifteen months was drawing nearer and nearer. it was the tramping of soldiers' feet. but this time there was a sound accompanying it which was even more disturbing. the other girls heard the same sound and almost at the same time jumped up from their seats. they went a few paces forward and then stopped and stared. a number of german soldiers were driving a group of belgian people before them like so many sheep. there were two old men and two middle-aged women with several small children. running further forward, barbara slipped her arm inside eugenia's. "what does this mean?" she queried, her eyes suddenly blurring with tears. yet she realized that the prisoners had probably been disloyal to their conquerors. they may have refused to obey the rules imposed by the german military commander of their district; they may have stolen food, or been insolent to the soldiers. although she appreciated their possible offences, barbara felt deeply sympathetic. for the past year and more she had been witnessing the suffering of the wounded soldiers in the british and french lines. she had thought that nothing else could ever touch her so deeply. yet in the last ten days she had been stirred in a different way. the soldiers were fighting for the cause nearest their hearts and enjoyed the enthusiasm and the glory of the soldier's life. but in belgium so many of the people appeared both helpless and hopeless; these were the old men, the women and the children. barbara was thinking of this now as she watched the pitiful little company before her. she had not even noticed that eugenia had made her no answer. now she was startled because the older girl had broken loose from her and was stalking out into the road. barbara was next amazed to see eugenia deliberately plant herself in front of the german officer in command. she spoke excellent german, knowing more of the language than any one of the four red cross girls. now barbara could only guess what eugenia was saying. but whatever it was, the german sergeant had stopped and was apparently listening respectfully. there must have been something impressive in her voice and manner. three minutes afterwards the other three girls were the more surprised to observe eugenia returning toward them. because in her arms she was carrying a tiny, black-eyed baby, while a small boy and a small girl clung to either side of her skirt. the boy was about nine or ten years old and was lame. "why, what does this mean, eugenia?" nona demanded, dropping on her knees to take the boy's small, cold hand in her own warm one. but the boy seemed to prefer eugenia, for he crept closer to her. "oh, it was nothing of any importance," eugenia began explaining quietly. "the sergeant told me he had orders to take the men and women into brussels. they are suspected of something or other and are to be put into prison. he said he had brought the children along because there was nothing else to do with them, so i offered to look after them." "but, but," mildred thornton faltered. "i know it is a painful situation, eugenia dear, but what _can_ you do with three babies? our house is already so full----" eugenia nodded. "yes, i understand, but i have already decided what to do. i'll stay here in the little one-room house with the children tonight. i looked it over the other day. there isn't any furniture, but we must manage for the night. you girls bring me over whatever covers you can spare and ask nicolete to bring all the food she can get hold of." "but you don't mean to stay here alone with these children in this perfectly forsaken place," barbara expostulated, dimly conscious that eugenia was becoming more of a puzzle than ever. do old maids now and then represent the real mother spirit? "i'll stay with you, eugenia," she added faintly, not altogether enjoying the prospect. but the older girl shook her head. "you have your own work to do, bab. only one of us can be spared. what possible danger could come to these little kiddies and me?" looking backward a few moments later, the three girls discovered that eugenia and the children had already disappeared inside the little house. chapter ii _a modern knight errant_ "i can't understand why you and nona are behaving so strangely, mildred. you have been whispering together all day. i am sure you are acting more like foolish school-girls than grown women," barbara commented in an annoyed tone. she was walking alongside her two taller friends with her head held as high as possible to make up for her lack of dignity in stature. two spots of angry color decorated her cheeks. for neither mildred nor nona had condescended to pay any attention to her remark. moreover, their whispering continued. the three girls were walking abreast along one of the suburban roads that lead into the city of brussels. it was a long walk, yet horses and motor cars were only used by the powerful in these days, except in cases of especial urgency. so as the three red cross girls were merely going into town to report at the red cross headquarters, there was no real reason why they should ride instead of walk. they had not objected to the walk; indeed, had been glad of the opportunity. but as barbara had found herself entirely left out of the conversation along the way, naturally she was beginning to find the road a tiresome one. brussels has always been thought to be a miniature paris. indeed, the belgian capital has been modeled on the larger city. but beside its art, nature has given it the same gayety of spirit and a portion of the same natural beauty. so it does not seem unreasonable that the two cities shed their tears together during the great war. yet the american girls had witnessed no such gloom in paris as they found in brussels. in paris one was at least able to talk freely against the enemy, to gesticulate with the abandon characteristic of the latin peoples. here in the belgian city one must be dumb, as well as hungry and sick at heart. to speak one's mind was to offend against his majesty, the kaiser, since everywhere in belgium the germans were now in command. therefore, as the girls reached the city they too became affected by the subdued atmosphere. of course, the people engaged in certain necessary occupations were about, but trading was very slight. in some of the cafés there were a few german soldiers. but not many of them were quartered in brussels, only a sufficient number to preserve peace and to enforce a surface loyalty to their conquerors. barbara and nona were in deep sympathy with the belgians. barbara because she was always enlisted on the side of the weak against the strong. nona, possibly because as a south carolina girl, she belonged to a country that had once been overrun by greater numbers. but mildred thornton and eugenia insisted that they intended to preserve neutral attitudes. they were red cross nurses, not soldiers, and there is always another side to every story. as nona's attention was so engaged by mildred, even after the three girls arrived in brussels, barbara had little to do except make observations. this was not their first trip to the red cross headquarters, but they did not yet know the city sufficiently well not to enter it as strangers. only in one place could barbara discover a crowd and that was wherever a church stood. women and children and an occasional elderly man were always entering and leaving the catholic churches. suddenly barbara thought of eugenia. why had she not come with them this afternoon? they had been told to report to the red cross headquarters in order to be assigned to their work. usually it was eugenia who rigidly insisted upon obedience to orders. what could she have in mind this afternoon of greater importance? barbara had paid a visit to eugenia and the three children earlier in the day. she had found them contentedly playing at housekeeping in the one-room shack, which must once have been a small storehouse. by one of the many miracles of war this little place had escaped destruction when the larger house was burned. eugenia, who was by nature a commander-in-chief, had set the children various tasks. bibo, the lame boy, was gathering chips from the charred, half-burned apple trees as cheerfully as a small grasshopper transformed into a thrifty ant. the girl, louise, was assisting nicolete to spread their scanty covering upon a freshly washed floor, sedate as a model chambermaid. barbara had watched them in some amusement before attempting to join eugenia. it seemed difficult to remember the scarlet poppy of a girl whom she had first seen dancing for the french soldiers, in the present nicolete. for one thing, eugenia had demanded that the french girl wear sober and conventional clothes. so gone was her scarlet skirt and cap! nicolete now wore an ordinary shirtwaist and skirt and a blue gingham apron. the clothes had once belonged to mildred thornton and nona had kindly altered them to fit. because the three girls had absolutely refused to allow eugenia to put her little french protégé into any of her ancient new england toilets. there were limits to the things an artistic nature could endure, barbara had protested. but why, after all, had nicolete decided to come away with them from her own beloved land? it was equally as mysterious to the three other girls as eugenia's adoption of the child. neither of them had discussed their reasons. as captain castaigne soon after his recovery had been ordered north with his regiment, he was not able to offer an explanation. the three american red cross girls were simply told that nicolete had no people of her own and did not wish to go back to the family who had formerly cared for her. but after barbara's survey of the cottage she had returned to the yard for a talk with eugenia. she had found her with the little belgian baby in her arms walking about the ruined house. even here in the streets of brussels, with so many other objects to absorb her attention, barbara again found herself wondering at the change in eugenia. she did not seem to care to be in their society as she had in the earlier part of their acquaintance. nevertheless, she was no longer so stern and dictatorial. today she had asked barbara's advice quite humbly about a number of things. yet she had refused point-blank to tell what she intended doing on this same afternoon. but barbara's reflections were suddenly ended by their arrival in front of a handsome house in brussels. it was a private mansion that had been given over to the relief work by general von bissing, the german military governor of belgium. they found the place crowded. in the hall there was a long line of belgians waiting assistance. yet the girls felt almost at home, there were so many of their own country people about. however, they were invited to wait in a small reception room until the superintendent could find time for them. the buildings in brussels have so far remained uninjured by the war. for although fighting had taken place all around the city, the surrender came before its destruction. the girls were ushered into what had once been an attractive sitting room. at one side there was a small sofa and here nona and mildred straightway seated themselves without regarding their friend. so once more barbara felt hurt and left out of things. by chance there was no chair near the sofa, but by this time she was far too much wounded to try to force herself into the conversation. however, barbara at least felt privileged to use her eyes. for some mysterious reason both mildred and nona were looking unusually cheerful. this was certainly odd in view of the fact that everything they had seen since coming into belgium was more than depressing. yet barbara decided that nona was uncommonly gay and excited. her eyes were a darker brown than usual and her cheeks had more color. there could be little doubt that she was exceptionally pretty most of the time and even prettier than usual today. moreover, mildred had lost her serious expression. her fine white teeth flashed every moment into a smile. animation was what mildred most needed and she had her full share today. "shall we tell barbara now?" distinctly barbara overheard mildred thornton whisper these few words. yet in return nona shook her head so decisively that mildred evidently changed her mind. when the door to their sitting room opened barbara had again fallen into a reverie. she heard some one enter the room, but supposing the man a messenger did not glance up. barbara's exclamation of surprise was due to the surprising behavior of her two companions. for mildred and nona at once jumped to their feet, and actually mildred ran forward a few steps with her arms outstretched. in amazement barbara at this moment turned her gaze upon the newcomer. immediately her face flushed and the tears started to her eyes, yet she would rather have perished than let either effect be discovered. however, she had only seen a young american fellow of about twenty-two or three years of age, dressed in a dark-blue serge suit. he looked extremely well and handsome, except for the fact that his left arm was apparently paralyzed. by this time mildred had thrown her arms about his neck and they were kissing each other with devoted affection. "i can't say how happy i am to see you, dick. it is the most beautiful thing that ever happened to have you here in belgium with us! i have scarcely been able to wait until today, and then i was so afraid you would not arrive in time." all this from the usually quiet mildred! however, dick thornton had finally ceased greeting his sister and turned to nona davis. nona seemed as glad to see him as mildred. she held his hand for some time and kept insisting upon her pleasure in meeting him again. nevertheless, after nona's greeting had occupied as long a time as possible, barbara meade made not the slightest effort to step forward and welcome her former friend. certainly his arrival explained mildred's and nona's mysterious behavior. yet what reason could there have been for not telling her they expected richard thornton's appearance in brussels on this particular afternoon? she had not offended against any one of the three of them, that she should have been so ignored! it was a very stiff barbara whom dick finally walked across the room to greet: eugenia at her best could never have appeared more uncomprising. with his hand extended dick involuntarily paused, while a curious expression showed on his face. "aren't you pleased to see me, barbara--miss meade?" he corrected himself. "i have not recovered, but i've found out that i can be of some little use with the relief work here in brussels with one arm. but besides wishing to be useful, i have four attractions to bring me to belgium." dick spoke in his old light-hearted fashion, although barbara could see that a part of it was pretense. "of course, i am glad to see you," she returned slowly. "but since i have been left out of the secret of your coming, you must understand that i am more surprised than anything else at present." "oh, certainly," dick answered, letting his arm drop to his side. for barbara had apparently not seen his extended hand. "dick was uncertain whether he could be of service and so asked us not to speak of his coming until he was positive," mildred apologized. "i wanted to tell you, barbara, but nona felt it best not to. she had the last letter with instructions from dick." barbara glanced toward nona and then at dick. assuredly there was an understanding between them. well, she must learn not to mind the feeling of being ignored since it would probably continue for some time to come. chapter iii _a secret mission_ on the same afternoon of dick thornton's coming into belgium eugenia started out alone on her unexplained errand. she left her recently acquired family in charge of the little french girl, nicolete. nicolete seemed happier with the children than she had been since her removal from france. indeed, the three american girls had sometimes wondered over her unfriendliness toward them and her unusual quiet. at their first meeting she had appeared such a gay, gypsy-like person. but eugenia did not walk to her engagement. by making a tremendous effort she had managed to hire an old horse and buggy. then, after she felt sure the other three red cross girls had departed on the road toward brussels, she set out. inside the wagon she carefully hid out of sight her bag of red cross supplies, although she did not wear her nurse's uniform. earlier in the day barbara had brought down her suitcase, so that she could appear in an ordinary street dress. driving along the road eugenia hoped to suggest that she was only off on an ordinary errand which could not interest any one who chanced to observe her. she was looking rather plain and tired and was unusually nervous, but this it would have been difficult to guess from her quiet manner. the country through which she passed was one of queer contrasts. there were many houses that had been destroyed by fire, but others that had not even been touched. in these places people were evidently making an effort to lead an ordinary, everyday existence. but they were all listless and discouraged. eugenia thought that the children must have forgotten how to play in this last year, when their land had suffered such sorrow. she wished that she might gather them all together in one great circle that should extend all over belgium and set them to laughing and playing once more. however, eugenia soon left the populated part of the neighborhood. she and her old horse wound their way along a stream and then came to a gate. there was no house in sight from the gate, but just as if she had been there before, eugenia got down and opened it. then she tied her horse behind a clump of trees inside the woods and with her bag of nursing supplies in her hand crept along on foot up a narrow path. every once and a while she would stop and glance cautiously about her. but no one was in sight to be interested in her proceedings. moreover, where could she be going? she seemed to have some end in view, and yet there was no place or person in the vicinity. any one familiar with the neighborhood could have explained that eugenia must be bent upon an utterly ridiculous errand. there was an old house about half a mile farther along, but it had been deserted long before the germans had ever set foot on conquered belgium. a tragedy had occurred in the house ten or fifteen years before, and ever afterwards the place had been supposed to be haunted. no one believed such nonsense, of course, since intelligent persons do not believe in ghosts. but the house was too far from the village, and was in too bad a state of repair to be a desirable residence. indeed, there were dozens of reasons why, after its owners moved, no one else cared to rent it. moreover, the house had also escaped the interest of the german invaders of the land. so why in the world should it be of so great interest to eugenia that she was making this lonely pilgrimage, without taking any one of the three red cross girls into her confidence? the house was of brick and a large one. every outside shutter was closed in front and the vines had so grown over them that they were half covered. there was a porch also in front, but the boards of the steps had long since rotted away. at first only a large toad appeared to greet eugenia. he eyed her distrustfully for a second, his round eyes bulging and his body rigid with suspicion. then he hopped behind his stone fortress, which chanced to be a large stone at the end of the path before the house. however, eugenia did not see him. neither did she attempt to go up the rickety steps. how absurd it would have been anyhow to have battered at the door of a mansion that had been uninhabited for years! instead she marched deliberately around the house and knocked at a door at the side. a few seconds after, this door was opened by a woman of middle age. she looked very worn and unhappy, but her face brightened at the sight of her guest. "i was so afraid you wouldn't, couldn't get here," she said. "i suppose you know you are taking a risk." eugenia nodded in her usual matter of fact fashion. "i promised your friend i would do my best," she returned. "will you please take me up to the room. you must make up your mind to get more air into this house. i don't think you need fear you will be suspected, if you managed to arrive here without being detected." "i _am_ afraid," the older woman answered. she was leading the way up a pair of back stairs that were in almost total darkness. "you see, i know i have been accused of sending information to my husband who is supposed to be at the front with the belgian army. i was about to be arrested and tried by a military court. i should have been sent to prison and i could not be separated from my family at such a time!" the last few words were whispered. because at this moment the woman's hand had touched a door knob which she was gently turning. the next she and eugenia were entering a large room at the back of the apparently deserted house. a window had been opened and an attempt made to clean this room. on the bed, with a single scanty cover over them, two persons were lying. one of them was a young boy and the other a man. both of them were extremely ill. eugenia realized this at a glance, but paid little attention to the man at first. for she suddenly had a complete understanding of madame carton's last words. the boy was such an exquisite little fellow of about ten years old. he had straight golden hair and gray eyes with darker lashes. there was the same high-bred, delicate look that one remembers in the picture of "the two little princes in the tower." through a peculiar source eugenia had already learned a portion of madame carton's story. she was a belgian woman whose home was one of the handsomest in the city of brussels. but after the city had been forced to surrender to the germans, madame carton had refused to give up her home unless the authorities expelled her by force. this for some reason they had appeared unwilling to do. however, a short time after the german occupancy of brussels, reports accusing madame carton of treason and rebellion began to be circulated. it was said that she was sending secret information to her husband, who was a colonel in the belgian army and on the personal staff of king albert. finally madame carton learned that her arrest was only a matter of a few hours. then it was that she had managed to escape to this deserted house with her family. so far it looked as if her whereabouts had remained undiscovered. one hour after eugenia's arrival she and madame carton were once more at the foot of the stairs. they had opened the side door to let in a tiny streak of light and air. "but, madame carton, i don't think it is possible," eugenia announced with her usual directness. "i am willing to do whatever i can to help nurse your little boy and the other patient, but i can come to you very seldom without being discovered. you see, i may be ordered to nurse in any part of belgium and i must do what i am told. is there any one here to assist you?" madame carton nodded. she had once been a very beautiful woman with the gray eyes and fair hair of her son. but the last year of witnessing the desolation of her people and her country had whitened her hair and made many lines in her face. "yes, i have an old family servant with me. i should never have been able to make the journey without her help. she and my little girl, who is six years old, are in hiding in another room in the attic of this house. years ago when i was a child i used to come here to play with friends who then owned this place. i suppose that is why i thought of our hiding here when the crisis came," madame carton explained quietly. "now if i return to brussels perhaps paul may be cared for. but you know what else would happen. it would be inevitable! even if i were not shot i must go to prison. can't you help me? can't you think of some way to save us _all_?" the older woman took hold of eugenia's hands and clung to them despairingly. "i know i am asking what looks like an impossible thing of you, and you a complete stranger! yet you look so strong and fine," madame carton's voice broke, but eugenia's touch was reassuring. "if only a doctor could come to us, perhaps with your advice i might manage the nursing myself," she continued. eugenia shook her head. "when dr. le page asked me to see you and gave me the directions, he said it was only because he dared not visit you himself," eugenia explained kindly, but with her usual avoidance of anything but the truth. "he insists that, although he is an american, he is suspected of feeling too much sympathy for the belgians. after warning you to escape he was questioned and believes he is still being watched. that is why he confided you to me, asking me to do the little i can to aid you. so if he should attempt to reach you out here, it would mean his arrest as well as yours. i am sorry," the girl ended. her words were simple enough in the face of so great a calamity. yet there was no mistaking their sympathy. madame carton appeared to surrender her judgment and her problem to eugenia for solution. "tell me, miss peabody, what do you think i should do?" she asked. "it is not worth while for me to say that i care little what becomes of me. shall i return to brussels and give us all up to the authorities?" eugenia did not answer immediately. when she spoke again she offered no explanation of her own meaning. "please wait a while, madame carton, if possible, until i can see you again?" she asked. "in case you are not discovered before then i may have a plan to suggest that will help you. but i cannot be sure. good-by and a good courage." then eugenia marched deliberately back to the place where her old horse was in waiting. she then drove unmolested to the tiny house that was sheltering nicolete and the three stray children. but on her way she was repeating to herself a phrase she had learned years before as a girl at the high school: "quorum omnium fortissimi sunt belgae," said cæsar nearly twenty centuries ago. "the bravest of all these are the belgians." eugenia thought the same thing today and for the same reason cæsar did. "because they are nearest to the germans, who dwell across the rhine, with whom they do continually wage war." chapter iv _plans for the future_ the moon shone down upon belgium as serenely as upon any unconquered land. two girls were walking slowly arm in arm along a stretch of country road. there was no one else in sight at the time, yet they seemed entirely unafraid. a quarter of a mile beyond them, however, a dim light burned in the window of a small frame house. near it was a tumbled mass of brick and stone. "we received our orders for work this afternoon, eugenia dear," barbara remarked. "they were sorry you were not with us. but you are to come in to headquarters as soon as possible, when arrangements will be made for you." unconsciously barbara sighed and although it was too dark in the moonlight to distinguish the expression on her face, her companion paused for a moment. "are you disappointed in what they wish you to do, barbara, child?" eugenia inquired more gently than she usually spoke. "you sound rather forlorn and 'wee' as the scotch sometimes say. of course, i know you are tired from the long trip into brussels and coming here to spend the night with me. it is lovely to have you for this quiet walk, but i'm afraid you'll find a bed on the floor a pretty hard resting place even for war times." "oh, i shan't mind. besides, i brought over some more bed-clothes," the younger girl answered, although her attention was not really fixed upon her reply. eugenia had guessed correctly in thinking barbara was tired. her face was very small and white, so that her eyes appeared almost unnaturally large and blue. her only color was in her lips, which drooped like a weary child's. "oh, yes, the work is all right. one can't expect an easy time of it these days. besides, i hope some day to prove to you, eugenia, that i did not come to europe to nurse in the red cross just for the sake of an adventure. of course, i shall never dare hope to do anything to compare with what you have done, or to be anything like you, but----" barbara's speech was interrupted by her friend's hand being laid firmly across her lips. "i prefer your not saying things like that," she answered in a tone that the other girl felt obliged to respect. it was not that eugenia was unduly modest. only that she had never appeared to desire to talk about her final experience in france. indeed, the other three girls had been provoked before this by her reticence. it was all very well for eugenia not to discuss before strangers her rescue and care of captain castaigne under such extraordinary difficulties. but it was tiresome of her never to be willing to relate the details of her experience to her most intimate companions. personally, barbara meade intended to hear the whole thing some day from beginning to end. then she would be able to tell the story to the countess amelie, who had become her own and nona's devoted friend. for captain castaigne had given only a brief account of the circumstances to his mother. actually he had been as reticent in the matter as eugenia. however, barbara was not in the mood tonight to demand other people's confessions. "if you are tired, suppose we sit down for a while," eugenia suggested. the two girls found a tree near by that had been uprooted by an underground explosion and lay face down upon the earth with its arms outspread, like a defeated giant. unconsciously they both sighed with relief and then smiled half humorously at each other. "we are all to work at the same hospital in brussels," barbara went on. "at least, mildred and nona and i have been chosen for the same place. i don't know about you. thank goodness, it is an american hospital and supported by our money!" "don't be prejudiced," eugenia remonstrated. but barbara shook her head impatiently. "how can one help being? you are only pretending to yourself that you are neutral. if the germans had been conquered, perhaps i should feel equally sorry for them. but to me belgium is like a gallant boy who went out with his head up and his lips smiling to do battle with a giant. the courage of it is like a song!" in silence eugenia agreed. then barbara leaned her curly brown head on her companion's arm. "i have a piece of news for you, gene," she added. "really, i came to you tonight to be the first to tell you. who do you think arrived in brussels today to help with the american relief work?" barbara did not wait for an answer to her question. "dick thornton!" she finished with a sudden indrawing of her breath. the older girl did not glance toward her companion. her attention seemed to be fixed upon a particularly effective june moon which was just emerging from a cloud-like veil. "that is tremendously good news, isn't it? and it is great of dick to insist on being useful in spite of his misfortune! but perhaps i am not so surprised as you think i ought to be, barbara. nona half confessed the possibility of his turning up to me several days ago. she told me i was not to speak of this, however, to you, because dick might not be able to come and he did not wish--" eugenia hesitated a second--"he did not wish _mildred_ to be disappointed. now i am particularly glad you are all to be in brussels. perhaps you may have a chance to see dick _nearly_ as often as you like." "yes, it will be awfully nice for mildred and nona and i am delighted for them," barbara interrupted, moving several feet away from her friend. "but i do hope you will be with us, eugenia, to associate with me! i hate to be in the way. and i am afraid i will be, under the circumstances." the younger girl had lowered her voice to the purest confidential tone. then, although they were quite alone, she looked carefully around before going on. "perhaps i haven't any right to say so, but i am almost sure there is a bond between nona davis and dick. i didn't dream of this when we were in paris together. but i know they have been writing each other constantly ever since. besides, if you had seen their meeting today!" she ceased talking, for eugenia was shaking her head in doubt. "but isn't nona one of the prettiest girls you ever saw and the most charming?" barbara demanded argumentatively the next instant. she seemed almost angry at the older girl's silent disagreement. this time eugenia inclined her head. "i have no idea of disputing nona's beauty or charm, or dick thornton's either. he is a splendid american fellow. and if one of you red cross girls must fall in love, certainly i should prefer you to fall in love with dick. however, at present i simply don't believe there is an affair between dick and nona." "but you'll see in time," barbara persisted. "yes, i'll see in time," eugenia concluded. then barbara crept closer again. "the moonlight, or something, makes me feel dismal," she confided. "i don't know why, but the moon gives me the blues far more than it ever makes me romantic. sometimes i wonder if we will ever get back home safely, all of us, without any illness or sorrow or anything," barbara ended vaguely. eugenia could be a remarkably comforting person when she liked. she made no reply at the moment, only drew the younger girl toward her. "now i have something to tell _you_, barbara. it is good of you to wish me to be in brussels with you, but i'm really not much good as a companion. you girls are ever so much happier without me, i feel sure, or i wouldn't desert you." "desert us?" barbara stiffened at once, forgetting the other subject of their conversation. "you don't mean, eugenia peabody, that you have decided to give up the red cross work and go back home? you, of all of us! i simply won't believe it. why, i thought you were the most devoted, the most----" eugenia laughed half-heartedly. "i didn't say i was going home, barbara," she protested. "but you are right in thinking i mean to give up my red cross work, at least if i am allowed to resign. i don't know why, but recently i don't seem to feel the same fondness for nursing. i kind of dread a great many things about it." barbara laid her hand caressingly upon eugenia's knee. really eugenia was growing so surprisingly human these days that one could scarcely recall the old eugenia. "oh, that is just because you are tired. i know you have always denied this, but you have never been exactly the same since your siege with captain castaigne. the responsibility and the work were too much for you. i don't think he was ever half grateful enough! the idea of his joining his regiment without coming to say good-by to you--just writing a letter! promise me you will go quietly away somewhere and rest for a few weeks, eugenia. then i know you'll feel like getting back into harness again. really, i need you to be with us. i haven't any backbone unless you are around to make me afraid of you." eugenia shook her head. "perhaps i shall not be very far away and we may be able to see each other now and then. i have been thinking of a scheme for several days, almost ever since we came into belgium. you remember i told you i had a good deal of money, but did not always know just how to spend it. well, i have found a way here. i am going to get a big house and i am going to fill it full to overflowing with the belgian babies and all the children who need an old maid mother to look after them. and i think i found the very house i need today. it is an old place that is supposed to be haunted and is far away from everything else. but it is big and has an old veranda. perhaps i'll still be doing red cross work if i take care of well babies as well as sick ones. do you think i'll make a great failure as a mother, bab?" she ended. without replying barbara's answer was yet sufficiently reassuring. at the same time she was wondering if these past few months had changed eugenia as much as she appeared to be changed. but perchance she had always been mistaken in her view of her. then both girls started suddenly to their feet. for the little french girl, nicolete, had come upon them unawares. she gave barbara a glance revealing but little affection. then beckoning eugenia mysteriously aside she soon ran off again like a sprite in the moonlight. chapter v _st. gudula_ several weeks later barbara meade walked down the steps of a house in brussels out into one of the streets near the palais de la nation. the house had once been a private residence, but since the coming of war into the heart of belgium had been turned into a relief hospital by the american red cross society. barbara walked slowly, looking at all the objects of interest along the way. she wore a dark-blue taffeta suit and white blouse and a small blue hat with a single white wing in it. evidently she was not in a hurry. indeed, she behaved more like an ordinary tourist than an overworked nurse. yet a glance into barbara's face would have suggested that she was dreadfully fagged and anxious to get away from the beaten track for a few hours. it chanced to be her one afternoon of leisure in the week, so for the time she had discarded her nurse's uniform. she was also trying to forget the trouble surrounding her and to appreciate the beauty and charm of brussels. yet barbara found it difficult to get into a mood of real enjoyment. these past few weeks represented the hardest work she had yet done, for the funds for the belgian relief work were getting painfully low. therefore, as there were still so many demands, the workers could only try to do double duty. finally barbara entered the church of st. gudula, which happened to be near at hand. it was a beautiful gothic building, dedicated to the patron saint of brussels. once inside, the girl strolled quietly about, feeling herself already rested and calmed from the simple beauty of the interior. the tall rounded pillars and sixteenth century stained glass represented a new world of color and beauty. although she was not a catholic, barbara could not refrain from saying a short prayer in the "chapel of notre-dame-de-deliverance" for the safety of the belgian people and their gallant king and queen. barbara was too loyal an american to believe that kings and queens were any longer useful as the heads of governments. nevertheless, as a noble man and woman, king albert and queen elizabeth of belgium, commanded her admiration and sympathy. since the outbreak of the war neither of them seem to have given thought to their royalty, remembering only their common humanity with the people of their land. already comforted by the few minutes of quiet, finally barbara slipped out of one of the side doors that chanced to be open. afterwards she stood looking about her in order to find out just where she was. the side street was almost entirely free from passers by. therefore, as barbara desired to inquire her way to the nearest tram line, she waited for a moment. at some distance down the street she could see the figure of a man walking in her direction. she did not look very closely or she might have discovered something familiar in the quick stride and the graceful carriage of the head and shoulders. the men of brussels are rather more french than flemish in their appearance, yet this man did not resemble a foreigner. indeed, he walked so much more rapidly than barbara expected that she was extremely startled when a voice said close beside her: "why, barbara, this is good luck. to think i have not seen you since the first afternoon of my arrival! i'm sorry you have been so tremendously busy every time i have had a chance to run into the hospital for a few moments. but mildred and nona have given me news of you." dick thornton had taken barbara's hand and was looking searchingly into her face. but after her first recognition of him she had dropped her lids, so it was not possible to see her eyes. "i have just been up to your hospital now, but could not get hold of either mildred or nona. i am sorry. nona had promised me, if she could be spared, to spend the afternoon seeing sights. i have investigated thirty destitute belgian families since eight o'clock this morning and reported their cases, so i feel rather in the need of being cheered." barbara's chin quivered a little, although it was not perceptible to her companion. "i am dreadfully sorry too," she answered the next instant. "certainly you are deserving of nona's society for a reward. and if i had only known your plan you might have carried it out. it is my afternoon of freedom, but i would very cheerfully have changed my time with nona." "you are awfully kind, i am sure," dick returned. but he scarcely showed the gratitude at barbara's suggestion that she expected. he glanced up at the beautiful gothic tower of the church near them, remarking irritably, "i expect you are quite as much in need of a rest as any one else. really, barbara, it is all very well to do the best one can to help these unfortunate people, but there is no especial point in killing yourself. you look wretchedly. you are not trying to play at being the patron saint of brussels, are you? is that why you haunt the church of saint gudula?" barbara smiled. "i am the farthest person from a saint in this world," she replied, wrinkling up her small nose with a faint return to her old self. "nona and mildred and i have decided recently that we haven't but one saint among us. and she is the last person i should ever have awarded the crown at our first meeting. moreover, i wouldn't dare present it to her now, if she could see or hear me in the act. she would probably destroy me utterly, because my saint is very human and sometimes has a dreadful temper, besides a desire to boss everybody else. i wonder if real saints ever had such traits of character? of course, you know i mean eugenia! i am on my way now to her hotel des enfants, if i can ever find the right street car. she already is taking care of twelve children, and i have never seen her nor her house since we separated. gene has promised to send some one to meet me at the end of the car line. her house is a deserted old place where a ghost is supposed to hold forth. but i am assured the ghost has not turned up recently. it is nice to have met you. good-by." and barbara was compelled to stop talking for lack of breath after her long speech, as she held out her hand. dick ignored the outstretched hand. his face had assumed a charming, boyish expression of pleading. barbara was reminded of the first days of their meeting in new york city. "i say, barbara, why can't i go along with you?" he demanded. "of course, i realize that for some reason or other you are down upon me. i am not such a chump as not to understand you could have seen me for a few minutes in these last few weeks if you had tried. but eugenia is friendly enough. i haven't seen her, but i had a stunning note from her. besides, as i sent her five of her twelve belgian babies, i think i've the right to find out if she is being good to them. i am a kind of a godfather to the bunch. let's stop by a shop and get some stuffed dolls and whistles and sugar plums. some of the belgian children i have discovered seemed to be forgetting how to play." barbara had not answered. indeed, dick had not intended to give her a chance. nevertheless, her expression had changed to a measure of its former brightness. it would be good fun to have dick on the afternoon's excursion! she had rather dreaded the journey alone into a strange part of the countryside, one might so easily get lost. beside, barbara knew in her heart of hearts that she had absolutely no right for her unfriendly attitude toward dick thornton. if he had chosen to treat her with less intimacy than in the beginning of their acquaintance, that was his own affair. if he now preferred nona to her--well, he only showed a better judgment in desiring the finer girl. barbara now put her hand in a friendly fashion on dick's sleeve. "i am awfully glad to have you come along and i am sure gene will be," she answered happily. "lead on, sir knight, to the nearest street car." after an hour's ride into the country, through one of belgium's suburbs, dick and barbara arrived at a tumble-down shed. eugenia had carefully described this shed as their first destination. not far off they found bibo waiting for them with a rickety old wagon and an ancient horse. money and eugenia's determined character had secured the forlorn equipage. for it was difficult to buy any kind of horse or wagon in these war days. however, the small driver, who was the boy eugenia had rescued some weeks before, drove with all the pomp of the king's coachman. that is, he allowed the old horse to pick her way along a grass-grown path for about a mile. then he invited his two passengers to get down, as there was no road up to the old house that a horse and wagon could travel. so dick and barbara found themselves for the first time in their acquaintance wandering along a country lane together. their position was not very romantic, however. barbara led the way along the same narrow avenue that eugenia had followed on the day of her first visit to the supposedly deserted place. yet although barbara almost ran along in her eagerness to arrive, dick noticed that she looked very thin. she was not the barbara of his first acquaintance; something had changed her. well, one could hardly go through the experiences of this war without changing, even if one were only an outsider. and dick thornton glanced at his own useless arm with a tightening of his lips. he probably owed his life to the little girl ahead of him. eugenia did not at first see her guests approaching until they had discovered her. she was in the front yard and the grass had been cut, so that there was a broad cleared space. moreover, every window of the supposedly haunted house was thrown wide open, so that the sun and air poured in. it was as little like either a deserted or a haunted house as one could humanly imagine. for there were eight or ten children at this moment in the yard with eugenia. she held a baby in her arms and a small boy stood close beside her. barbara saw the little fellow at the same moment she recognized her friend. instantly she decided that he was the most exquisite child she had ever seen in her life. the boy was like a small prince, although he wore only the blue cotton overalls and light shirt such as the other boys wore. but he must have said something to eugenia, for she glanced up and then ran forward to meet her guests. the baby she dumped hastily into her discarded chair. "but i thought i was to be your guest of honor, gene?" barbara protested a few moments later. "never should i have allowed dick to come if i had dreamed he was to put me in the shade so completely." eugenia laughed. her new responsibilities did not appear to have overburdened her. "come and meet my family," she insisted. "there was an old woman who lived in a shoe, who had so many children she didn't know what to do." chapter vi _the locked door_ "but she seems to me a very unusual person to be a servant, gene," barbara remarked argumentatively. "of course, i know she was wearing a maid's apron and cap so that her hair was completely hidden, and her dark glasses concealed her eyes. still, i could see very plainly the woman you call 'louise' is not an everyday servant. she spoke to dick and me with perfect self-possession, although she did seem nervous. but it is ridiculous to think one can hide a personality under such a slight disguise." barbara spoke pettishly. she and eugenia were wandering about the big house together. they were looking over the arrangements eugenia had made for her recently acquired family. these were, of course, of the most primitive kind. there were about eighteen army cots in the bedrooms, some light coverings, and a few wooden chairs. in the big front room downstairs long planks had been laid across wooden supports. this formed a large and informal dining room table. yet by accident this same room contained a magnificent flemish oak sideboard that had been left in the house by the former owners of the place. however, barbara and eugenia were in eugenia's own bedroom when the present conversation started. they had already seen the lower floor of the house, where barbara had been introduced to eugenia's cook, who was a plain flemish woman. but it was the history of the housemaid, a woman of between forty and fifty, whose identity barbara was questioning. in reply eugenia gazed at her friend earnestly for a few moments and then slowly shook her head. "these are war times, bab. i thought you and i had agreed long ago to ask no unnecessary questions." eugenia had seated herself on the side of her cot bed, barbara was on a high wooden box, which served as a chair, near the window. she did not reply at first, but this was merely because she was thinking, not because she intended to consider eugenia's suggestion. she had one foot crossed under her, while the other swung in the air. her brow was wrinkled into a painfully heavy frown for so miniature a person. unconsciously barbara pulled meditatively at a brown curl that had escaped from the knot at the back of her head. during her long study eugenia smiled at her guest. she too could not grow accustomed to considering barbara as responsible a person as the rest of the red cross girls. this was only because of her appearance, for she had learned to have faith in her. all of a sudden barbara began talking again, just where she had left off. "it is all very well to preach, gene, about not asking unnecessary questions because we are living and working in war times. but you know very well we never expected that point of view to apply to asking questions of each other. we came abroad as strangers, except that mildred and i knew each other slightly, but since then we have become friends. at least, we care a great deal about each other's interests. now i don't think for a minute we have the right to keep secrets from one another. that is, unless they happen to be of a kind one simply can't bear to tell." and at this barbara hesitated for an instant. "but about this woman, this 'louise', we were discussing. eugenia, you know perfectly well she isn't a real servant. i am dreadfully afraid you are hiding some one and it may get you into serious trouble," the younger girl continued, making no effort to hide her anxiety. "really, you ought to be careful, gene. you came to europe to act as a red cross nurse, not to interfere with questions of government. if you do, you may be put into prison, or something else dreadful. do you know i thought all along it was funny your deciding so suddenly to give up your red cross work and then knowing exactly where to find a house. well, i might as well tell you," barbara now got off her stool and came over and put a hand on either of her friend's shoulders, "i mean to find out what you are trying to hide if i possibly can," she concluded. eugenia did not stir. but she let her own dark eyes rest gravely upon bab's blue ones. "please don't," she asked. "i suppose i might have guessed that you would have discovered there is something unusual about my family. but, bab, i want you to promise me on your honor that you will not mention your suspicion to any one--not to nona, or mildred, or dick thornton. i am trying in a fashion to help some one who is in deep trouble. as you have guessed, she is a woman, and that was her little boy, jan, whom you saw standing by me when you arrived. but if questions are asked of you, barbara, you know absolutely nothing of this. i prefer to manage my own affairs." eugenia made this announcement in her haughtiest fashion. however, her companion was not deceived. eugenia simply meant that if disaster followed her attempt to shield a prisoner, she alone must bear the penalty. quietly for another moment, still with her hands on the older girl's shoulders, barbara continued to consider the situation. "i won't make you any promises, gene," she answered at last. "i must decide what to do later. but i won't tell nona, or mildred, or dick, as i can't see any special point in confiding in them at present. however, i am not willing to stand aside and let you run deliberately into danger. it was all very well your taking care of captain castaigne. he was desperately ill. your finding him wounded on the battlefield was so romantic. but this is quite a different affair. we were under certain obligations to the countess amelie, while this 'louise' and her 'jan' are utter strangers. i think i'll go this instant and tell the woman she has no right to make you undergo such risks." again eugenia did not stir, but this time neither did barbara. "you will do no such thing, my dear; you must let me manage my life for myself," she declared quietly instead. "of course, i am not going to take any more chances than i must. come now, let us go downstairs and have tea. you and dick were angels to have come on such a long journey and you must be nearly famished. i have managed to get a few supplies in brussels and i have sent to boston for a great many more. so when you girls are able to visit me, we can at least regale ourselves with a boston tea party." eugenia put an arm across barbara's shoulder as they moved toward the door. a few feet further on the younger girl stopped. "are you very rich, eugenia peabody?" she demanded. "unless you are, it is perfectly mad for you to have undertaken the expenses of this household. most of these children have not had anything to eat for a year and must be nearly famished." eugenia nodded. "i suppose i am fairly wealthy, although i find it hard to realize it, as i grew up such a poor girl." "then why--why, eugenia (i have been simply dying to ask you this ever since you told us you were rich)--why did you wear such old-fashioned--if you will excuse me--such perfectly awful clothes?" barbara fairly shuddered, recalling how she and nona and mildred had suffered over eugenia's ancient alpine hat. but eugenia only laughed. she had been sensitive enough over the other girls' attitude toward her appearance when they first knew one another. but barbara's way of expressing things was too absurd. "i told you i had been so poor i didn't know how to spend money," she explained. "besides, i have always been so plain it never occurred to me that clothes could make much difference in my appearance." "goose!" barbara looked up at eugenia searchingly. "if ever this wretched war is over, i mean to go with you to paris and make you spend heaps and heaps of money on clothes. nona and i have decided that we could make you look quite stunning if we had the money to spend. then i should insist that you pay a visit to the chateau d'amelie. the countess insisted you never could look like anything but a new england old maid, no matter what exquisite toilets you wore." then the younger girl's cheeks grew so hot that she could actually feel the tears being forced into her eyes. "i wonder if i shall ever learn what to say and what not to say, gene?" she asked wretchedly. "oh, don't tell me you don't mind what i say. that is not the point. the trouble is i can't learn when to hold my tongue. i only wish the countess could have seen you when dick and i arrived today." eugenia was not wearing her nurse's uniform. instead, she had fished an old gray crepon dress out of her trunk. but in order to make it more attractive for her little guests, she wore a white fichu about her neck. then her hair was wound in two heavy braids around her head. "there isn't any particular reason why i should deny being an old maid," she returned. "only i am sorry that you girls discussed my appearance with a stranger." again barbara flushed. "the countess isn't a stranger to us, gene," she apologized, "and i don't think you should feel that way toward her since you and captain castaigne have grown to be good friends. i don't see how you can still consider him unattractive. but you are terribly prejudiced, eugenia." the two girls had left eugenia's bedroom and were now walking toward the back stairs. all of a sudden, when eugenia chanced to be unconscious of her companion, barbara moved away. she at once placed her hand on the knob of a door leading into a room at the back of the house. "whose room is this, eugenia? may i go inside and see?" she queried. her hand was upon the knob, but, of course, she made no effort to enter the room, awaiting the other girl's reply. she was interested merely because this seemed to be about the only room that eugenia had not exhibited. but eugenia immediately looked unaccountably angry. yet she had kept her temper perfectly through all barbara's annoying speeches! "please don't attempt to go in that room, barbara!" she ordered sharply, quite in the manner and temper of the former eugenia. "if i had desired you to see the room i should have taken you into it myself." "oh, i beg your pardon," barbara replied, angry with herself for the sudden lump that had risen in her throat. "i suppose this room is bluebeard's chamber, or the place where you keep your ghost locked up. i did not mean to interfere." "the room is not locked and is entirely empty," eugenia replied. however, she must have parted with her new england conscience at the moment of making this statement. for barbara had distinctly heard some one moving about inside the room. and quite by accident, as her hand turned the knob, she realized that the door _was_ locked. in the yard the two girls found dick thornton playing with the children. he had discovered some ivy growing on one side of the old house. therefore, each girl and boy had been decorated with an ivy leaf, as if it were a badge of honor. moreover, dick also wore a leaf in his buttonhole. "louise" soon brought the tea, which dick drank with satisfaction. barbara tried to pretend that she enjoyed hers, but it was extremely difficult. not that she was angry with eugenia, for her discomfort went deeper than that. the fact is she was frightened for her. some one more important than "louise" was being guarded by eugenia. who on earth the man or woman could be, barbara could not even hazard a guess. yet it must be some one whose safety her friend considered of great importance, for had she not deliberately lied to her? certainly eugenia was facing a grave situation! at present no one suspected her of treason. she was simply regarded as an eccentric american woman, who desired to spend her money in caring for the destitute belgian children. no outsider had yet visited her "hotel des enfants." but, of course, once the news that something unusual was going on in her establishment reached the german authorities, eugenia could not hope to escape their vigilance a second time. on the trip back into brussels dick thornton found his companion unusually quiet. he was under the impression that it was because of the change in her once friendly attitude toward him. he was sorry, because he very much wanted to talk to her about a personal matter, but never found a sufficiently intimate moment. only once did she arouse herself in the effort to make conversation. "why do you happen to be wearing that spray of ivy so proudly, dick?" she inquired carelessly. "i was amused at your decorating all the belgian children with leaves." dick glanced carefully about, but the tram car was almost empty. "don't you understand what the ivy means?" he asked. "i expect it _was_ pretty absurd of me. but the other day the german commandant ordered that no belgian should wear his national colors. indeed, they were not to be displayed anywhere. well, the result is, that almost everybody one meets upon the street has been wearing a leaf of ivy lately." dick took the ivy spray from his coat and handed it to his companion. "do you know what ivy stands for?" he asked. "it means attachment, faithful unto death. won't you wear this?" but although barbara took the shaded, dark green leaf into her hand and looked at it for a moment, she slowly shook her head. "there is something charming and pathetic in the idea, dick. remember to tell the story to mildred and nona. and give the ivy to nona; i am sure she would love to have it," barbara finished, as she gave the leaf back to her companion. chapter vii _a triangle_ a curious division had developed between the four american red cross girls since their arrival in belgium. perhaps this was due to the arrangement of their work, perhaps to spiritual conditions which are not always easy to see or define. eugenia, for reasons of her own, had given up the regular red cross nursing, preferring to devote herself to the children whom the war had made homeless. after barbara's first visit to her and the discussion that had arisen between them, she had not urged the younger girl to come to see her often. barbara had been several times without invitation, but had not referred to their past difference. indeed, she hoped that eugenia would believe the idea had completely vanished from her mind. nevertheless, she watched affairs at the old house more closely than her friend dreamed. there were other suspicious circumstances that barbara kept tabulated. later on, if she considered eugenia in danger, she meant to fight for her and with her when the occasion arose. however, barbara had her own life and labor to occupy her time and was apparently busier than ever before. for although she and nona and mildred were working at the same hospital, they saw very little of one another. the american red cross hospitals in brussels were not given up entirely to the care of the wounded soldiers. the germans looked after their own men and their prisoners as well. but there were many ill and friendless belgians, unable to leave their country, who must have died without the help of the american red cross. fifty thousand belgian babies were born during the first year of the present war. their fathers had either been killed in defence of their country or were away at the front fighting with their king. so there were fifty thousand mothers as well as babies who must be looked after. barbara's work was among the women and children in the american hospital, while mildred and nona were engaged in general nursing. the hospital was not a large one; indeed, it had been a private home before the coming of the germans. but the red cross societies of the united states had outfitted the hospital and only american doctors and nurses were taking part in the relief work. so both from choice and opportunity mildred and nona were frequently together. they shared the same bedroom and grew daily more intimate. this had not been true at first. indeed, barbara had appeared as the favorite of both girls, until a new bond had developed between them. always mildred thornton had been peculiarly devoted to her brother, dick. even in his selfish, indolent days in new york city she had been unable to see his faults. in her heart she had resented barbara meade's criticism of him. now it was charming to find that nona was as enthusiastic about dick as she was. whenever the opportunity came, the three of them used to go upon long excursions about brussels. they visited the royal museums, the palais des beaux arts, the parks, the palais de justice, which is the largest and most beautiful modern building in the world. and these parties did each member of the expedition a great deal of good. no one of them ever neglected work for pleasure, but the occasional happy times kept them cheerful and well. it might have been better for barbara had she shared these amusements. but after inviting her three or four times, finding that she always refused, the others made no further efforts to persuade her. for they seemed to be extremely content to be three, in spite of the old adage. indeed, mildred cherished the unexpressed hope that dick might be falling in love with nona. so whenever it was possible she used to leave the two of them together. but she was wise enough never to have made this conspicuous. neither had she intimated any such idea either to her friend or brother. but it was fairly simple to find one self interested in a picture at one end of a gallery when her two companions were strolling in the opposite direction. also one could grow suddenly weary just as the others had expressed the desire to investigate some remote picture or scene. certainly it is not usual for a devoted sister to wish her only brother to marry. but then, mildred thornton was an exceptional girl. selfishness had never been one of her characteristics, and, moreover, she was deeply devoted to nona. besides this, she felt that the best possible thing that could happen to dick was to marry an attractive girl. for ever since the loss of the use of his arm mildred had feared that he might become morose and unhappy. indeed, he had seemed both of these things during their stay in paris. it was only since coming into brussels that he had regained a portion of his old debonair spirit. so naturally mildred believed nona to have been largely responsible for this. there were few people in their senses who would have cared at the present time to dispute nona davis' charm and beauty. she had always been a pretty girl, but the past year in europe had given her a delicate loveliness that made persons stop to gaze at her as she passed them on the street. a great deal of her former shyness had passed away. in spite of the hard work and the sight of so much undeserved suffering, she had grown stronger physically. for before coming to europe nona had led too shut-in and conservative a life. she had almost no friends of her own age and her poverty was not a pretence like eugenia's, but a very certain and to her a very distasteful thing. nona wanted to see the world and to occupy an important place in it. in spite of her real talent for her work and her unusual courage under danger, she had no thought of being a hospital nurse all her life. nona's father was an old man at her birth. he had once belonged to a family of wealth and prominence. but after the civil war had destroyed his fortune he had made little effort to rise superior to circumstances. yet he had spent a great many hours talking to nona about the true position which she _should_ occupy and telling her long stories of her family's past. charleston, south carolina, is one of the most beautiful and at the same time one of the most old-fashioned cities in the world. the tide of the new american life and spirit has in a measure swept past it. at least the new americanism had never entered the doors of nona's home during her father's lifetime. the old gentleman would have perished had he dreamed of his daughter's becoming a trained nurse. however, after his death nona had felt a strong impulse toward the profession and so far had never regretted the step. but it was true that she had been greatly influenced by the possible romance and adventure in her decision to help with the red cross work in europe. this did not mean that nona was not tremendously in earnest. but she was a girl who had read a great deal and dreamed many dreams. all her life poetry and passion would appeal to her more than cold arrangements of facts. there was no fault in this, it was merely a matter of temperament. perhaps it was partly responsible for the soft light in nona's brown eyes with their curiously golden iris. also she had a fashion of opening her lips slightly when she was specially interested in a subject, as if she wished to breathe in the essence of the idea. a part of nona's dreaming was due to the fact that she had never known her mother after she was a small girl. more than this, she had been brought up in such curious ignorance of her mother's history. any child in the world must have dreamed strange dreams under like circumstances. often nona used to have a vision of her mother coming to stand at her bedside. always she appeared dressed in the white muslin and blue ribbons, in which she remembered seeing her on a special sunday afternoon. moreover, there was always the question of her mother's family to be pondered over. naturally nona believed that her mother must have been a great lady. her imagination even went so far as to conceive of her as a foreign princess, who for reasons of state had been suddenly carried off to her own land. until she grew old enough to laugh at herself, nona often sat with her delicate little nose pressed against the window pane in the drawing room of her old charleston home. if questions were asked she could invent many reasons to explain her presence. she was actually waiting for a splendid coach and four to drive up to the door and bear her away. the coach was always decorated with a splendid coat of arms, and for some absurd childish reason the coachman and footmen were dressed in pumpkin-colored satin and wore tall black top hats. as a matter of fact, as nona davis grew older these ridiculous fancies faded; nevertheless, a few of her old dreams remained. for one thing, she retained the impression that her mother had probably been a foreigner. yet she never could understand why, even after her father's death, his few old friends continued to decline to give her any information. surely one of them must know something of her mother. it was all too mysterious and disheartening. on coming to europe, nona had made up her mind to put the trying mystery back of her and to forget it as completely as she could. in a measure she had succeeded, but since her confession to the red cross girls the old haunting desire had come back to her. she _must_ find out whether her mother was dead or living and in either case why she had been told nothing of her. then suddenly one day, without knowing why, she chose dick thornton for a confidant. more than this, she asked for his advice. whatever the mystery, it was her right to be told the exact truth, she insisted, and dick agreed with her. this was on one of the occasions when they were walking together out from brussels in the direction of the sea. they were not allowed to travel very far, since the roads were all patrolled by german soldiers in command of the fortifications along the way. mildred had chosen to rest for a few moments, so that dick and nona were alone. not that mildred's presence would have interfered; this was simply an accident. dick listened with unusual gravity to nona's history. perhaps it struck him as even queerer than it did the girl herself. she had always been accustomed to the mystery. really, the entire story sounded like a fabrication. mysteries were out of fashion in these modern days in the united states. although, of course, there was nothing too mad or too inconceivable that was not taking place in europe at the present time. nothing was more antagonistic to dick thornton's nature than concealment of any kind. yet he felt profoundly touched by nona's confession. the girl herself was so attractive! she was still wearing the black silk dress and hat she had bought in paris the autumn before. her face had flushed, partly from embarrassment and partly from the emotion she always felt at any mention of her mother. her eyes were luminous and brown and her features as exquisitely carved as a greek statue's. dick also had no other idea except that nona's mother must have been a woman of grace and breeding. the daughter was entirely aristocratic to the tips of her slender fingers. for half a moment dick thought of suggesting that he or mildred write to their own mother for advice. in reality mrs. thornton would have enjoyed tremendously the unveiling of an _agreeable_ mystery. but only if she should discover in the end that nona was the heir to a fortune or a great name. if the conclusion of the mystery were disagreeable mrs. thornton would be profoundly bored. therefore he naturally hesitated. "i don't know exactly what to advise, nona," he confessed, since they were by this time calling each other by their first names. "the sensible thing is to write to your lawyer and demand to be told all that can be found out. if there are any letters or papers, you must be twenty-one, so they are legally yours. then perhaps with something to go on, you can find out the truth later for yourself. only please don't consider my advice too seriously." here dick's manner and voice both changed. he had grown accustomed to relying upon his own strength and decision in the past year. yet every once in a while he remembered that not many months before he had seldom given a serious thought to any subject except deciding what girl he should invite to the theater or a dance. "it was awfully kind of you to have thought my judgment worth while," he concluded. then his sudden turning of the subject of conversation surprised nona. "i have a secret of my own which i may some day tell you, because i hope to have the benefit of your advice," he added. "at present i am not sure whether it would be wise to speak of it. for so far there is nothing to be done with my secret but smile and bear it like a man." then dick smiled. "do you know, i have been thinking lately that perhaps it is the women who smile and bear their burdens. a man is rather apt to want to make a noise when he is hurt." nona glanced down at dick's sleeve. "i don't think you have a right to accuse yourself of that fault," she said gently. but dick shook his head. "i was not thinking of my arm; i am learning to get on fairly comfortably with one arm these days." chapter viii _a prison and a prisoner_ one afternoon one of the young doctors in the american hospital invited barbara to go with him to visit one of the german prisons. these prisons sheltered a number of wounded british and french soldiers. there were scarcely a sufficient number of hospitals to take care of the german wounded alone. dr. mason, the young american surgeon, was about twenty-five years old. he had been sent into belgium by the red cross societies in his own village in minnesota. so, although his home and barbara meade's were many miles apart, at least they were both westerners. on this score they had claimed a fellow feeling for each other. the truth was dr. mason felt sorry for barbara. she seemed so young and so much alone in the unhappy country they had come to serve. she did not seem to wish to be intimate with the other american nurses at their hospital and her two former friends evidently neglected her. so only with the thought of being kind, dr. mason had issued his invitation. he was not attracted by barbara. she seemed rather an insignificant little thing except for her big blue eyes. this was partly because barbara so seldom laughed these days. there was little in belgium that one could consider amusing. just now and then she did manage to bubble over inside when no one was noticing. for there is no world so sad or so dull that it does not offer an occasional opportunity for laughter. certainly an excursion to a prison could scarcely be considered an amusing expedition. nevertheless, barbara accepted the invitation with alacrity, although she had previously declined far pleasanter suggestions from dick thornton and the two girls. but she had several reasons for her present decision. she liked dr. mason and she was interested to see the inside of a german prison. moreover, it was not unpleasant to have her friends find out that other persons found her agreeable. have you ever been in the ridiculous state of mind of secretly yearning to be intimate with an old friend and yet refusing the opportunity when it is offered you? it is a common enough state of mind and usually comes from a curious combination of wounded pride and affection. yet it is a difficult mood to get the better of and often one must wait for time to bring the adjustment. if barbara had not been a red cross nurse she would never have been allowed to accompany the american surgeon to the german prison. but as he might need some one to assist him in cases of severe illness among the prisoners, barbara's presence would not be resented. the prison was a short distance out from the city of brussels. it had formerly been used for persons committing civil offenses, but was now a military prison. the building was of rough stone and was situated in the center of a large court yard. it was built around an enclosed square, where the prisoners were sometimes allowed to enjoy air and exercise. but conditions were not so unpleasant here as in many other places, although the discipline was fairly severe. for the germans were making their prisoners useful. in the early spring crops had been planted by the imprisoned men upon many of the waste spaces of conquered belgium. now the prisoners were employed in reaping some of the harvests. only a small proportion of the food would ever fall to their consumption, yet the work in the fields was far better for the health and spirits of the captured men than idleness. it left them less time for thinking of home and for fretting over the cruel fortunes of war. barbara and dr. mason drove out to the german prison in one of the automobiles connected with their hospital. on the outside frame of the car was the red cross sign with their motto: "humanity and neutrality." the german commandant of the prison was a big, blond fellow, disposed to be friendly. straightway he invited the two americans to investigate the prison, declaring that the germans had nothing to conceal in the treatment of their captives. dr. mason, however, was a strictly business-like person. he insisted upon seeing the sick men first. after doing what he could to relieve them, if there were time, they would then be pleased to inspect the prison. so barbara and the young physician were shown into a big room on the top floor of the building. a sentry sat on a stool outside the door. inside there were a dozen cots, but not another article of furniture. the room was fairly clean, but was lighted only by two small windows near the ceiling and crossed with heavy iron bars. on the cots were half a dozen french and as many english soldiers. several of them were evidently very ill, the others were merely weak and languid. a heavy-footed german woman, more stupid than unkind, was the solitary nurse. once again barbara had a return of her half whimsical, half sorrowful outlook upon life. this excursion with dr. mason was in no sense a pleasant one. for no sooner had she entered the sick room than she moved with her peculiar light swiftness toward the bed of a young soldier. his arms were thrown up over his head, as if even the faint light in the room tortured him. barbara pulled his arms gently down. as she did this he made no effort to resist, but murmured something in french which she could not comprehend. yet at the same moment she discovered that the boy's eyes were bandaged and that he had a quantity of yellow hair, curling all over his head in ringlets like a baby's. the german nurse strode over beside them. "he is blind; no hope!" she announced bluntly. at the same instant barbara's arms went around the boy soldier. for hours he must have been fighting this terrible nightmare alone. now to hear his own worst fears confirmed in such a cold, unfeeling fashion swept the last vestige of his courage away. barbara literally held the young fellow in her arms while he shook as if with ague. then he sobbed as if the crying tore at his throat. barbara made no effort not to cry with him. she kept murmuring little broken french phrases of endearment which she had learned from her year's work in france, all the time patting the boy's shoulder. he was a splendidly built young fellow with a broad chest and strong young arms. even his injury and the confinement had not broken his physical strength. this made the thought of his affliction even harder to bear, to think that so much fine vigor must be lost from the world's work. "i don't believe it is true that you are going to be blind forever," barbara whispered, as soon as she could find her voice. she had no real reason for her statement, except that the boy must be comforted for the moment. but he had covered up his eyes as though the light hurt them, and if he were totally blind neither light nor darkness would matter. dr. mason had at once crossed the room to talk to another patient. but at the sound of sobbing, he had turned to find his companion. certainly barbara was entirely unconscious of the charming picture she made. she was so tiny, and yet it was her strength and her sympathy at this moment that were actually supporting the young soldier. never before had the young american physician looked closely at barbara. now he wondered how he could ever have believed her anything but pretty. her white forehead was wrinkled with almost motherly sympathy. then even while her eyes overflowed, her red lips took a determined line. with a glance over her shoulder she summoned the physician. "please tell this boy you will do everything in your power to see that his eyes are looked after before it is too late," she pleaded. then she stood up, still with her hand on the young frenchman's shoulder. "i am a red cross nurse. this is dr. mason, one of the surgeons who is giving his services to the american hospital in brussels," she explained to the boy, who had by this time managed to regain control of himself. "miss winifred holt is coming over from new york just to look after the soldiers whose eyes have been injured in this war," barbara continued. "besides, i know there are eye specialists here who must be able to do something for you." barbara's tone each instant grew more reassuring. "i am sure dr. mason and i will both persuade the prison officers to let you have the best of care. they are sure to be willing to have us do all that is possible for you." by this time the young fellow had straightened himself up and taken hold of barbara's other hand. "you are more than kind," he answered, speaking with the peculiar courtesy of the french, "but it is useless! a shell exploded too near my face. no matter, it is all in the day's business! i was only thinking of my mother and our little farmhouse in provence and of the french girl, nicolete, who used to dance before our soldiers." suddenly barbara smelt the odor of pinks and mignonette. for odors are more intimately associated with one's memories than any other of the senses. then the next moment barbara saw eugenia and herself standing near the opening of a trench in southern france. as usual, they were arguing. but they were interrupted by a french soldier boy, who stood beside them holding out a small bunch of flowers. he had light hair and big blue eyes and rosy cheeks like a girl's. "monsieur bebé," barbara whispered. relieved that dr. mason and the german nurse had both been called to attend to another patient, barbara now climbed up on the cot and sat beside the french boy. "i want to tell you something that no one else must hear," she went on, lowering her voice until it was as mysterious as possible. "you do not know it, but you and i are old friends. at least, we have met before, and that is enough to make us friends in war times. besides, you once gave me a bouquet. do you remember two red cross nurses to whom you gave some flowers that you and the other soldiers had made grow in the mouth of your trench? then afterwards we both watched nicolete dance and you threw her a spray of mignonette?" "yes, yes," the boy answered, clutching now at barbara's skirt as if she were a real link with his own beloved land. "it is the good god who has sent you here to help me. you will write my mother and say things are well with me. it will be time enough for her to hear the truth if i ever go home." "you are going to get well, but if you don't you shall at least go home," barbara returned resolutely. "the germans are exchanging prisoners, you know. but i have another secret to tell you if you will promise not to tell." the boy, who had been crying like a cruelly hurt child the moment before, was now smiling almost happily. barbara could be a little witch when she chose. she put her own curly brown head in its white nurse's cap down close beside the boy's blond one. "what would you give to have that same little french girl, nicolete, talk to you some day not very far off?" she whispered. then she told the story of nicolete's coming into belgium with eugenia and of her living not far away in the house which eugenia had taken. but she also made the boy promise not to breathe to any one the fact of nicolete's identity. she was not supposed to be a french girl, but a little belgian maid under the protection of a wealthy but eccentric american red cross nurse. by the time barbara had finished this conversation she was compelled to hurry away. but she promised to come again to the prison as soon as she was allowed. dr. mason needed her help. there was far more work to be done than he expected. for the next two hours barbara assisted in putting on bandages, in washing ugly places with antiseptic dressings, in doing a dozen difficult tasks. nevertheless, whenever dr. mason had a chance to glance toward his assistant she managed to smile back at him. it was a trick barbara had when nursing. it was never a silly or an unsympathetic smile. it merely expressed her own readiness to meet the situation as cheerfully as possible. but before the afternoon's work was over the young american doctor had become convinced that she was the pluckiest little girl he had ever worked with. what was more, she was one of the prettiest. however, though the nurse and doctor were both worn out when their service for the day was over, they were not to be allowed to return to the hospital at once. the german officer in command still insisted that they be shown about the prison building and yard. chapter ix _a second acquaintance_ barbara did not enjoy the thought of being shown over the prison. for one thing, she was tired; another, she feared she would find the imprisoned soldiers terribly downcast. she had nursed among them so long she felt a deep sympathy for their misfortunes. yet she discovered that the imprisoned soldiers go through about the same variety of moods as men and women engaged in ordinary occupations. they have their sad days and their cheerful days. there are times when the confinement and depression seem unendurable, and others when a letter comes from home with good news. then one is immediately buoyed up. it was now between four and five o'clock on a summer's afternoon. barbara and dr. mason went through the prison hastily. there was nothing interesting in the sight of the ugly, over-crowded rooms; but fortunately at this hour most of the men were out of doors. so, as soon as they were allowed, the two americans gladly followed the german commandant out into the fresh air. they had not been permitted to talk to the prisoners and dr. mason had made no such effort. it was merely through the courtesy of the german commandant that the american physician and nurse were given the privilege of visiting the ill prisoners. therefore, dr. mason considered it a part of his duty not to break any of the prison rules. but barbara, being a woman, had no such proper respect for authority. whenever the others were not looking she had frequently managed to speak a few words. but she breathed better when they were again outdoors. it had been hot and sultry inside the prison, but now a breeze was blowing, stirring the leaves of the solitary tree in the prison yard to a gentle murmuring. underneath this tree was a group of a dozen or more soldiers. some of them were smoking cherished pipes, while others were reading letters, yellow and dirty from frequent handling. the international red cross had done its best to secure humane treatment for all the war prisoners in europe. for this purpose there is a bureau of prisoners, having its headquarters in geneva, switzerland. they have sent forth a petition to the various governments at war, asking among other things that prisoners be allowed to receive money, letters and packages from their friends. these last must of course be carefully censored, and yet they keep life from growing unendurably dull. think of long weeks and months going past with never a line from the outside world! barbara studied the faces of the imprisoned men closely. with all her experiences as a war nurse it chanced she had never before seen any number of prisoners. now and then a few of them had passed her, being marched along the belgian roads to the measure of the german goose step. now she managed to bow to the men resting under the tree and they returned her greeting in the friendliest fashion. every red cross nurse is a soldier's friend. yet in the character of an ordinary girl barbara would have been almost as cordially received. she looked so natural and so human. somehow one recalled once again the vision of "the girl one had left behind." but barbara was not to linger inside the prison yard. as the day was nearing its close the men who had been working in the fields were to return. the german commandant wished dr. mason to see how well his prisoners looked. surrounding the prison was a high stone wall. in the rear of this yard was a wide gate which could be swung back on hinges, allowing a half dozen men to be herded through at the same time. so dr. mason and barbara were escorted outside the prison wall and given chairs to await the marching past of the soldiers. barbara sat down gratefully enough. but when five or ten minutes passed and nothing happened she found herself growing bored. dr. mason could not talk to her. the german officer was discoursing so earnestly in his own language that it was plain the american physician had to devote all his energies to the effort to understand him. so by and by, when neither of the men was observing her, barbara got up and strolled a few paces away. there was little to see except the stretch of much-traveled road. the fields where the prisoners were at work were more than a mile away. but the girl's attention was arrested by an unmistakable sound. it was the noise of the imprisoned soldiers being marched back to their jail. the tread was slow and dead, without animation or life. it was as if the men had been engaged in tasks in which they had little concern and were being returned to a place they hated. barbara stood close to the edge of the road along which the men must pass. she was naturally not thinking of herself. so it had not occurred to her that the soldiers might be surprised by her unexpected appearance. she was frowning and her blue eyes were wide open with excitement. she had left her nurse's coat thrown over the back of her chair. so she wore her american red cross uniform, whose white and crimson made a spot of bright color in the late afternoon's light. a young french soldier in the first line of prisoners chanced to catch barbara's eye. she smiled at him, half wistful and half friendly. instantly the young fellow's hand went up to his cap, as he offered her the salute a soldier pays his superior officer. then the prisoners were all seized with the same idea at the same time. for as each line of soldiers, with their guards on either side, passed the spot where barbara was standing, every hand rose in salute. the girl was deeply touched. but she was not alone in this feeling. the american physician had a husky sensation in his throat and his glasses became suddenly blurred. the german commandant of the prison said "a-hum, a-hum," in an unnecessarily loud tone. there was nothing in the spectacle of the girl herself being thus honored by the imprisoned men that was particularly affecting. the truth was it was not barbara who was being saluted, but the uniform she wore, the white ground with its cross of crimson. in a world of hate and confusion and sometimes of despair the red cross still commands universal respect. barbara could not see distinctly the faces of the soldiers. she recognized them to be both french and english and of various ages and ranks. but there were too many of them and they moved too rapidly to study the individual faces. however, as the men finally entered the prison gate the line halted a moment. then something must have occurred to delay them still more. six or eight rows of men were compelled to stand at attention. one of the guards near barbara moved ahead to find out what caused the obstruction. this was barbara's chance to get a good look at the soldiers. so she began with the one in the line directly opposite her. the young man was undeniably an englishman. he was about six feet tall and as lean as possible without illness. he wore no hat and his hair was tawny as the hay he had just been cutting. moreover, his eyes were the almost startling blue that one only sees with a bronzed skin. he did not look unhappy or bored, but extremely wide awake and "fit," as the english say. besides this, he seemed enormously interested in barbara. obviously the young soldier was a gentleman, and yet equally obvious was the fact that he was staring. all at once barbara moved forward a few steps until she was nearer the prisoner than she should have been. this was because she had seen him somewhere before but could not for the moment recall his name. "lieutenant hume!" barbara exclaimed suddenly under her breath. "i am sorry; i did not know you were a prisoner!" the young soldier did not move a muscle in his face, yet his eyes answered the girl with sufficient eloquence. there was not a second to be lost. barbara knew the prisoner was not allowed to speak to her. also she was not expected to speak to him. but she had an unlooked-for chance to say a few words, and what feminine person would have failed to seize the opportunity! "we are nursing here in brussels, all of us," she went on rapidly, keeping as careful a lookout as possible. "the other girls will be grieved to hear of your bad luck. if possible, would you like one of us to write you?" for half a second lieutenant hume's rigidity relaxed. yet once again his answer was in the look he flashed at the girl. then next the order came. the soldiers were marched inside the prison and the gate swung to. immediately after barbara and dr. mason started back to the hospital. really, barbara felt ashamed of herself, she was such an extraordinarily dull companion during the return journey. but she was both tired and excited. what an extraordinary experience to have spent a few hours at a german prison and to have discovered two acquaintances. true, poor monsieur bebé was scarcely an acquaintance, yet she had seen and spoken to him before. as for lieutenant hume, he was almost a friend. at least, he had been a friend of nona's. she would be grieved to hear of his misfortune and no doubt would try to be kind to him if it were possible. as for barbara, she meant to devote her energies to doing what she could for the young frenchman. if he were totally blind, surely the german authorities might be persuaded to exchange him for one of their own men, should proper interest be shown in his case. as soon as possible barbara decided she would go and consult eugenia. she would be sure to have some intelligent suggestion to make. barbara and dr. mason said farewell to each other outside the hospital front door, as the man had other work before him. just as he was leaving the girl slipped her small hand inside his. "i have had a more interesting afternoon than you realize," she insisted, "and thank you for taking me with you. i am sorry that i have been such a tiresome companion on our way home." the young man smiled down upon the tired little nurse. the fact that she was a nurse struck him as an absurdity, as it did almost every one else. "you have been a perfect trump, miss meade, and if anybody is to blame it is i, for taking you upon such a fatiguing expedition. will you go with me upon a more cheerful excursion some day?" barbara nodded. dr. mason was looking at her with the frankest admiration and friendship. it was good to be admired and liked. then she turned and disappeared inside the big hospital door. dr. mason continued to think of her until he reached the house of his next patient. chapter x _a discussion, not an argument_ "but very probably you were mistaken in thinking it was lieutenant hume," nona announced. "i am sure he had not been taken prisoner when we left france." barbara raised herself on one elbow in her small bed and answered irritably: "i most certainly was not mistaken, nona davis. i ought to know robert hume perfectly well after our meeting in paris and his visit at the chateau. besides, though he dared not speak, he showed that he recognized me. i even promised him that you would write him a note to the prison if it were possible." then barbara relaxed and sank down on her pillow again. she and nona and mildred were in her small room at the hospital. it was time for them all to have been in bed and asleep, since they chanced not to be engaged in night nursing. but barbara had retired early, as she was extremely tired. then, some time after, nona and mildred had crept in to find out what had become of her. they had missed her during the afternoon, but had not known of her expedition with dr. mason. now nona looked annoyed. "what an extraordinary thing, barbara, for you to promise! i am sure i see no reason in the world why i should write lieutenant hume. we are only acquaintances. of course, i am sorry to know he is in hard luck. but for me to begin writing him under the circumstances would look as if we were intimate friends." barbara slipped her arms up over her head, making a kind of oval frame for her face. nona and mildred were seated on either side the foot of her bed. "i think you are absurd, nona," she commented, in the frank fashion which was not always either advisable or pleasant. "i really don't believe i did say you would write, only that one of us would. naturally, i thought as you knew lieutenant hume best you would prefer it. i don't consider he would think you were being _too_ friendly with him. he is too much of a gentleman. he would understand that you were sorry for his hard luck and pitied his loneliness. i wonder if it was because you were brought up in the south that you are so conventional? you don't seem to be so all the time, only when it suits you. i am sure i will write the note to lieutenant hume with pleasure if i find he is allowed to receive letters except from his family." evidently barbara was in a mood when it made but little difference to her whether or not she made nona davis angry. yet she and nona had once seemed to be devoted to each other and appeared to be friendly now. nona, however, was not given to quarreling. so, although she flushed uncomfortably, she made no immediate answer. mildred, however, broke into the conversation hastily. "well, you did have an extraordinarily interesting afternoon, barbara, though it must have been a trying one. i confess nona and dick and i were all hurt when we found you had gone out without even speaking of your intention. we have asked you to go with us any number of times. dick said he did not suppose you knew any one in the hospital well enough to have accepted an invitation." at this barbara rose up to a half-sitting position, still with her arm-encircled head leaning against her pile of pillows. "was dick here this afternoon?" she inquired, wondering within herself why she felt pleased over dick's hearing of her departure. "oh, he only stopped by for a moment to bring nona a book," mildred added. "i just chanced to see them as i was passing by in the hall. but you look very tired, barbara. would you like nona and me to leave you? you can tell us more of your experiences another time. but i advise you to ask dick if he can make any suggestions about the poor little frenchman. monsieur bebé sounds so pathetic. you know dick may have something worth while to propose. he is doing such splendid work with the relief committee." barbara patted mildred's hand gently and, it must be confessed, a little condescendingly. "you are apt to think dick does everything well, mill, aren't you," she announced, "whether it is looking after the starving belgians or leading a dance in a ball room? still, i don't think i shall trouble him. i have a plan of my own in mind for the boy and i am going out to see eugenia to ask if she thinks it feasible. then if she thinks it is, i shall go ahead and see what can be accomplished." "and leave all of us completely in the dark," nona added. "i must confess, barbara, i don't think it kind of you to speak to mildred about dick in such a superior, almost scornful, fashion. in the last few weeks we have both been aware that you did not care to be intimate with us. but whatever we may have done, i can't see how dick thornton can have merited your disapproval. i don't believe you have even seen him alone." barbara's cheeks flared. "and i wonder how you formed that opinion, nona? however, it strikes me as none of your business." the instant barbara had made this speech she was sorry. one was always at a disadvantage in a quarrel with nona davis. for nona never for a moment forgot her dignity or breeding. she was white now, while barbara was crimson. her lips were curling a little scornfully, but she answered quietly, "i am sorry to have made you angry; that was not my intention." however, in spite of her apology, the younger girl remained absurdly aggrieved. yet she had the grace to turn to mildred. "i am sure you understand, mildred, that i never intended to be disagreeable about dick. you must know that i admire him very much." mildred leaned over and deliberately pinched barbara's flushed cheeks. "i know you are a little goose," she asserted, "to be quarreling with nona as though you were two badly brought up children." but barbara was not to be appeased. she made no answer, and the next moment nona slipped off the bed and knelt on the floor beside her. "what is the matter, bab? what is it that has been making you feel and behave so differently toward me lately? if i have been to blame in any way i apologize with all my heart. i confess i was absurd about lieutenant hume. i liked him very much the few times we met. i might at least be willing to do the poor fellow a kindness when he is in hard luck. but you see, he does not belong to a very good family in england. though he behaves like a gentleman, after all he is only a gardener's son." it was not barbara who interrupted this time, but mildred thornton. "that is nonsense, nona," she protested. "i have heard you say something of that kind two or three times. anyone who has traveled in the least knows that no gardener's son in england is educated as lieutenant hume is, nor has such perfectly self-possessed manners. besides, he is a lieutenant." nona shook her head. "yes, i know it does sound impossible," she returned. "but lieutenant hume told me himself that he was the son of the gardener when i first met him in surrey. he was at home then, recovering from a wound in the leg and was lying asleep near the gardener's cottage. it has often struck me as queer since, but i have worked it all out. lieutenant hume must have been educated by some one who considered him unusual. and commissions have been given in the british army in this war for merit as well as for family reasons." but nona was evidently weary of the subject of the young english lieutenant. she had remained kneeling on the floor and she now took hold of barbara's somewhat limp hand in a very sweet fashion. "but you haven't said what the trouble is between us, bab, or whether you are willing to forgive me?" she continued. "i should feel very unhappy if anything serious interrupted our friendship. eugenia seems so far away these days and i don't believe she is anxious to have us come to see her often." "oh, eugenia is busy," barbara answered carelessly. "but it is all right, nona; of course i am not angry with you. i was vexed for a moment, but i expect that was because i am tired. it is ridiculous to suggest that there could be any serious trouble between us." to the best of her ability barbara tried to speak with sincerity. nona looked exquisitely pretty and appealing as she knelt beside her. one would have forgiven her almost any offense. yet barbara could not truthfully convince herself that nona had committed an offense against her. nevertheless, she did not feel a return of her affection, although she struggled to have her manner at least appear unchanged. but nona was conscious of the difference, for she rose immediately to her feet. "i am sorry we disturbed you tonight when you were so tired," she said, holding her chin just a little higher than usual. there was no change in the soft inflections of her voice. "good night." then nona left the room without looking back. but mildred stopped to kiss barbara. "you haven't been any too nice to me either, mistress barbara," she asserted. "if you don't reform i shall tell dick and make him find out the reason why." of course mildred made this speech without in the least meaning it. nevertheless, after both girls had left the room and she should have been asleep, barbara remembered. she sincerely hoped that mildred would not be so tiresome as to tell dick of their personal differences. but what was the root of the trouble between her and her two former friends? for the life of her barbara could not decide. or, if at the depth of her heart she knew, she was not brave enough to confess the truth to herself. chapter xi _monsieur bebé_ one sultry august afternoon barbara went again to see eugenia. this time she went alone. according to his usual custom bibo met her at the end of the car line with his ancient horse. owing to his lameness perhaps, he was head coachman to eugenia's establishment, which barbara still insisted upon calling "l'hotel des enfants." bibo was looking extremely well. he had on long trousers of blue cotton and a blue cotton smock with a round collar. he had lost the frightened, starved look which barbara remembered seeing on the evening of his rescue. the boy's face was round, there was a dimple in one corner of his brown cheek. his eyes were serene save for his sense of responsibility as barbara's escort. it is true that bibo's mother was still held a prisoner in brussels because of an act of disrespect to a german officer. but children's memories do not harass them so long as they are happy. "how are things going, bibo?" barbara asked in french, as soon as she was seated beside her driver. fortunately, french was the language of eugenia's belgium family rather than flemish. bibo first flapped his reins and then nodded enthusiastically. words at the moment appeared to fail him, although he was usually voluble. "then gene is well?" barbara continued. for after many difficulties eugenia had acquired this informal title. in the beginning the children had struggled nobly with her name, but miss peabody was too much for them. then "miss eugenia" was equally difficult for little belgian tongues, so it became madame gene. later, since eugenia did not enjoy being called madame, nor was she more fond of mademoiselle, her name attained its simplest form among the younger children. but eugenia was bibo's altar saint and he was not inclined to take liberties. saint gene she had been to him in truth! "she is well," he answered briefly. then he allowed his round eyes to leave his horse and turn ecstatically toward barbara. "in a few days my mother is to be with us. she wrote that she need stay no longer in prison and that she wished to see me, but alas, there was no place for us to go! our home near louvain was burned and my father--" the tones of the boy's voice expressed his uncertainty of his father's fate. "but my friend has written that my mother may come to our home; she will help us look after the other children. all will be well!" bibo's tone was so grown-up and he was so evidently quoting eugenia that his companion smiled. but the smile was because bibo could not possibly understand how one _could_ cry over good news. how big was eugenia's house and her sympathy these days? certainly she seemed to wish it to include all who needed her help. "and monsieur bebé?" barbara next queried. "does he appear more cheerful since i left him with you a week ago?" the boy hesitated a little. "he laughed twice this morning and he sits all day in the sun and smiles now and then when nicolete is beside him. but no one can be cheerful and blind." this was spoken with conviction. of his own affliction bibo seldom thought, but indeed his lameness troubled him very little now. he could run and walk almost as well as the other boys. it had been hard at first, for until the day when their house had burned and they had been forced to escape, he had been exactly like other boys. but he had been stupid then and fallen. there had been no time to heal the hurt in his leg, so bibo must hobble as best he might through an indifferent world. but barbara seemed extraordinarily well pleased by her companion's information. poor monsieur bebé had been so far from smiling even once during his weeks in the prison hospital. and barbara felt that she could claim some of the credit along with eugenia for his release and better fortune. soon after her visit to the prison she had secured a prominent surgeon to go and look at the young frenchman's eyes. the man could offer him little comfort. there was every chance that monsieur bebé, whose name was reney, must continue blind. a little hope he might have, but hope was not encouragement. in the depression that followed this announcement barbara did her best to help the boy. but it was plain to his fellow prisoners and to the prison officers that the news had broken his health and spirit. he had no wish to live. he would not eat and after a time made no effort to get out of bed. he would lie all day without speaking, but rarely uttering a complaint. everybody was sorry for him, the big german nurse, the german guards, even the commandant of the prison. it was one thing to kill an enemy in the passion of battle, but another to see a boy, who had done one no personal harm, slowly passing away in darkness. so when barbara came to the german commandant with her plea for his prisoner's parole, he was willing to listen to her. "what possible harm could be done if monsieur bebé, in reality albert reney, be transferred to eugenia's home in the woods? she had offered the french boy shelter and care. he would make no effort to escape, but even if he should, a blind man could never again fight for his country. moreover, germany was arranging with the allies for an exchange of blind prisoners. it was possible that monsieur reney might later on be sent home." eugenia was waiting this time near the place where barbara was compelled to descend from bibo's wagon. she had only one of her children with her, which was unusual, since she ordinarily went about with five or six. but jan and bibo were her two shadows. they were marked contrasts, since bibo was so plainly a little son of the belgian soil, the child and grandchild of farmers. jan came of the men and women who have lived among pictures and books and helped make the history of his now tragic land. the boy jan was so instinctively a gentleman that, although he was not ten years old, he immediately upon barbara's arrival slipped behind the two friends. for his happiness' sake he wished to keep his eyes fastened upon his gene, but he must not be close enough to overhear conversation that would not be intended for him. eugenia took barbara's face between her beautiful, firm hands and gazed at her closely. although in the first instant she saw that the girl wore the same look of the past few weeks, she said nothing. only she put her arm about her as they walked toward the house. barbara did not feel like talking at first. she had been coming every week recently to the house in the woods and the visits always rested her. it did not seem possible that a few months could make so great a change as they had in eugenia. one could scarcely have recognized her as the same girl who set sail from new york city a little more than a year before. but she was also changed from the girl who had crossed over from france earlier in the summer. in spite of her responsibilities eugenia had grown ever so much larger; all the angular curves were gone, her chin was softly rounded. beneath her pallor there was now a soft glow of pink, and best of all, the severe lines about her mouth had almost completely vanished. they could return if she were displeased, but the children rarely saw them. "something very worth while has come to you, gene," barbara whispered. "i wish you felt you could tell me what it is. is it because you enjoy looking after the belgian children?" eugenia nodded. "it is that and something else, but i don't feel that i can ever explain to any one." then barbara and eugenia were interrupted by two persons coming toward them from the opposite direction. one was a splendid, big blond fellow whose eyes were bandaged. he was being led by a girl of about sixteen with jet-black hair which she wore short to her shoulders. she had dark eyes and crimson lips. nicolete's costume and manner had both changed since her departure from france. but it was not possible to change the vivid coloring of her face. both the girl and boy were chattering rapidly, and both of them seemed happier than barbara had lately seen them. "the truth is all french people are homesick outside of their beloved france," barbara thought to herself. "so it must be a consolation to have a fellow countryman for a companion." but monsieur bebé was tremendously pleased to hear barbara's voice. he asked her to take his hand and lead him back to his chair in the garden before the once deserted house. there, as a small chair chanced to be beside his, barbara sat down. then nicolete and eugenia went away to prepare tea. monsieur bebé did his best to express his thanks to barbara and he had the frenchman's grace and choice of words. he was of course still desperately sad over his affliction, but meant if possible to meet it like a man. he had been willing to die for his country, but perhaps it took more courage to go on living for her. miss peabody had promised that as soon as possible he should begin to learn a trade. after a quarter of an hour's talk barbara felt in better spirits than she had on her arrival. perhaps this was the secret with eugenia. she was feeling that she was being useful to some one. it might help heal another kind of hurt. certainly barbara could feel that her interest in the young frenchman had been worth while. the two friends saw little of each other during the rest of the afternoon. but this was the usual thing and barbara did not mind. she continued to stay out in the yard, sometimes watching the children play and at other times leading the games herself. eugenia came and went, now and then stopping for a few words of conversation. "louise," the maid, rarely appeared. in all barbara's visits she and "louise" had not exchanged a dozen sentences. indeed, it was self-evident that the woman did not wish to be noticed. barbara respected her desire. however, she understood perfectly by this time that "louise" was not a servant, but some one who was living in eugenia's house in order to conceal herself and her children. jan had forgotten instructions and several times spoken to "louise" as mother. there was also a little girl who was with her the greater part of the time. but barbara asked no more questions. so far no trouble had come from eugenia's kindness. perhaps this "louise" was a person of no especial importance, whom the german authorities would not take the trouble to seek. of the person behind the locked door, nothing more had been seen or heard. only barbara had never been allowed to go into that particular room. none of these things were troubling her this afternoon. possibly she might try and talk them over with eugenia later, although she really did not expect to. but she meant to stay all night and eugenia had promised to spend an hour or so before bedtime alone with her. it was a marvelous august night with the most perfect moon of the year. the day had been hot, but the coolness came, as it nearly always does, toward evening. nevertheless, eugenia and barbara decided to leave the house for a short walk. there was little chance for privacy indoors, as every room was now occupied and eugenia had been compelled to take nicolete in with her. so at about nine o'clock, when most of the members of the household had retired, eugenia and her guest started out. eugenia wore a dark red sweater and cap and barbara white ones, which she kept in the country for the purpose. neither girl intended to go far from home. eugenia's house was in a comparatively deserted part of the countryside. there were no other places near. but for that very reason in case of difficulty there would be no one to offer aid. to the left of eugenia's was a big, uncultivated field. on the other side was the woods with the path which connected with her yard. the children often played in the woods near by, but in taking a walk persons were compelled to follow the traveled path. if one wandered away for any distance there was danger of getting lost. not that the woods were particularly thick, but because they had been neglected and underbrush had grown up between the trees. therefore, as soon as the two girls walked the length of their yard they turned into the usual path. the woods were in reality only another portion of the abandoned estate. the moonlight was so bright that the path looked like a strip of white ribbon ahead. then, though the foliage of the trees made beautiful, dense shadows, one could see distinctly in between them. chapter xii _the ghost_ the girls had been talking over certain details in connection with the management of eugenia's establishment. she found it extremely difficult to buy provisions. but neither one of them was giving thought to what she said. it was eugenia, however, who offered the interruption. "please let's don't talk about things that are of no importance, bab, when i see you so seldom," she protested. "tell me, please, about dick thornton and mildred and nona. dick and nona were out here a few moments the other day, but i had no chance to have any conversation with them. i thought they both looked extraordinarily well to be working so hard. i never believed nona as strong as you, barbara, so why do you seem so used up? is your work at the hospital more difficult than hers?" "certainly not," the other girl answered. "really, eugenia, i don't think it kind of you, or of other people, to keep on telling me i don't look well. i have assured you a dozen times i am all right. if you continue suggesting the other thing i shall probably fall ill. but nona and dick do seem well and cheerful, and so is mildred for that matter. i think it is because they are all very happy over something. no one has spoken of it to me so i am only guessing. but it is true, isn't it, eugenia, that if one is happy oneself, it is not hard to bear the sufferings of other people? yet it seems to me that belgium is scarcely the place to make one cheerful." instead of replying eugenia laughed. the cynicism in barbara's tone was so unlike her. yet one could realize that she did not mean to be disagreeable. really she was confused and needed information. "oh, i suppose one's own happiness is of chief importance," eugenia finally returned. "it isn't human to expect people to be utterly wretched over others' sorrows. one can be sympathetic, of course, and depressed now and then, but that is about all." then they walked on a few yards in silence before the older girl added: "are you speaking of the same thing, bab, that we discussed one night in the moonlight a good many weeks ago? i believe it was the first evening after dick thornton arrived in brussels? because if you are, i still don't agree with you. of course, i have been separated from the rest of you most of the time lately, yet i don't think i am mistaken. what makes you believe as you do, barbara?" the older girl put this question in as careless a tone as possible. then, although she and her companion were walking arm in arm, she did not glance toward her. she did not even try to get an impression of her expression in the moonlight. barbara shrugged her shoulders. "there are many signs, eugenia, and they cannot always be defined. but i don't think _you_ would ever see or understand them." the slighting emphasis upon the pronoun was unmistakable; nevertheless, eugenia only smiled. once barbara's point of view might have hurt her, but tonight she was not thinking of herself. she had something else upon her mind, but was uncertain whether it would be wise to discuss the subject, or leave it still in darkness. "well, perhaps you are right, barbara," she admitted. "i had a note from nona yesterday, but she made no reference to dick. she wanted me to ask you a question for her, which perhaps neither of us has the right to ask. i don't know, it has worried me a good deal----" she stopped because barbara had turned in the path and was facing her half belligerently and half affectionately. "don't be a goose, eugenia, ask me anything you like. certainly i have bored you enough recently with my bad tempers and complaints to have you say whatever you wish to me. it's funny, eugenia, but when we started for europe i was sure i was going to like you less than any one of the girls. now you are the only one i care very much about." with this barbara laughed, pretending that she was not altogether in earnest. but there was no humor in her laughter. eugenia received her information gravely. "that may be good of you, dear, but i don't believe you," she returned. "still i am glad you made the remark just at this minute. it helps me with what i wish to say to you. nona wanted me to find out what it was that had changed your feeling for her. she says she has done her best to discover for herself and has asked you to tell her, but without success. she seems much distressed and is anxious to make amends if she has injured you." the older girl had to cease talking because barbara had pulled away and was walking on ahead without pretending to answer. she was being rude and was aware of it. but it was better to be rude than to have any human being discover how crimson her face had become and how her lips were trembling. eugenia's question had taken her so by surprise. several weeks before she had gone through much the same kind of conversation with nona and mildred. but the subject had never been mentioned again and she hoped was happily over. it was too stupid to have nona go on dwelling upon the matter in this way and utterly pointless. she had told her that she had nothing in the world against her. surely one had the right to one's likes and dislikes! quietly eugenia continued after her guest. she made no effort to stop her, although she realized that they were walking farther than they had intended. finally barbara must have appreciated the fact, because she stopped and turned around. "let's go back home, i am dead tired," she murmured. of course eugenia complied, and they continued in single file on the return journey. walking alone, barbara once or twice thought that she heard some one tramping about in the underbrush not far away. but although she glanced over in that direction she saw no one. after five minutes more of silence barbara caught up with eugenia, who was in the lead on the way home. "can we stop a minute somewhere, gene, before we get back to the house? i have something i want to tell you. i believe i'll feel relieved once i have made a plain statement of a fact to myself as well as to you. and it will be easier to say it out here in the moonlight than in the light of day." this time it was the older girl who hesitated. "you said you were tired, bab, and it is getting late. besides, i am not sure it is wise for us to be so far from the house alone." she turned her head uneasily toward the left side of the woods. it was on the same side that barbara had believed she heard a noise. but at present she was paying no attention. "please do as i ask you; a few minutes more cannot make any difference." then, just as they had two months before, the girls found a fallen tree and seated themselves on the trunk. but barbara turned around so that she could look directly at her companion. a shaft of light shone straight across her face. eugenia could see that the characteristic little frown was there as well as the slight wrinkling of the short, straight nose. also that barbara's eyes were serious, although the expression of her mouth was partly humorous. she looked very young and charming. perhaps she was not so beautiful as many other girls. yet she had a kind of mocking grace, an evanescent, will o' the wisp quality that was more fascinating than ordinary beauty. then beside this, she was so thoroughly human. "yes, i have a grievance against nona, a perfectly dreadful one. when i told her i didn't have, i just lied," she began directly. "fact of the matter is, i can't forgive nona for being more attractive than i am. i can't tell her this to her face though, can i, eugenia? nor can i see exactly how i can let _you_ tell her." barbara clasped her hands together. they felt very warm, although the evening was cool. but then her cheeks were even hotter. nevertheless, a smile at herself, perhaps the best smile there is in the world, flickered around the corners of barbara's mouth. "i know perfectly well what you are thinking, eugenia. nona has not changed recently. if i cannot like her now because she is prettier and more charming than i am, then why did i like her at the beginning of our acquaintance? she was both those things then. but the fact is, i didn't care then, because, because--oh, why is it so hard to get it out, gene? i don't see why girls need always be ashamed of caring for people who don't care for them? i didn't know at first how much dick thornton was going to be interested in nona davis, nor how much i cared for dick. there, the worst is out and i am glad of it!" then barbara dropped her chin into her hands and sat staring at the moon up over the top of the trees, waiting for her companion to answer. eugenia remained silent. "are you disgusted with me, gene?" the younger girl asked the next moment. "goodness knows, i have been with myself, though i never confessed the truth to any one, not even to barbara meade, until this second. i haven't any right in the world to like dick except as a friend. he has always been only ordinarily nice and polite to me. i really never thought of him seriously until after we left paris. then when i found out he was writing to nona and never to me, i was terribly hurt. i had believed we were better friends than he and nona. at first i didn't see why i should mind so much, then by degrees i suppose i began to find out. anyhow, the only reason i have for not liking nona at present is jealousy. it is about the ugliest fault there is, so i'm not very proud of myself. but as i intend to make a clean breast of the subject tonight and then never mention it again, you might as well hear the rest. i don't like mildred so much as i used to, because she evidently prefers to have nona for dick's friend than to have me. and there are times when i'd like to pinch her." it was so absurd of barbara to end her confession with this anti-climax. yet the older girl was not deceived. because she endeavored to make fun of herself and of the situation, she was no less in earnest. "why don't you say something, gene?" she pleaded the next instant. "what shall i do? am i ever going to be sensible again?" perhaps it was because eugenia had been devoting herself to caring for children for the past two months, or perhaps it was because she had so strongly the mother feeling. for at this moment she wanted to take barbara in her arms. really, there was not very much for her to say under the circumstances. should she insist that dick was not in love with nona when she knew absolutely nothing about it? this would, only make things harder for the other girl in the end. barbara was not a foolish, sentimental person; she was usually clear-sighted, with sound common sense. of course, she would stop caring for dick thornton after a time if he felt no affection for her. but how convince her of this at the present moment? "i had been fearing something like this, barbara," eugenia said finally. "i don't mean in connection with nona. i never dreamed of her entering into the situation. dick is a splendid fellow, but after all he has only one arm. besides, i don't think judge thornton is really wealthy. they spend a great deal of money. i know from all i have heard that judge thornton makes a great deal, but that mrs. thornton is very extravagant and very ambitious." barbara got up. "let's go to bed, gene dear. of course, nothing you can say will make any difference. but i promise to turn over a new leaf. away with all human weakness!" barbara started to wave her hand, but instead clutched at eugenia's arm frantically. "great heavens, who was that, gene?" she whispered. "i am sure i saw some one sliding along between the trees. he was crouched over as if he feared we might see him." eugenia took the younger girl's arm. "it was no one, my dear. but remember, this is a haunted house and a ghost is supposed to wander all over the estate. keep hold of my hand and we'll run to the house. perhaps we may get there before the ghost does." chapter xiii _an arrest_ "i want you to know that i understand who the ghost was last night, eugenia," barbara said unexpectedly next morning. eugenia was just about to leave her bedroom, nicolete having gone downstairs half an hour before. at these words the older girl turned and stood straight and severe with her shoulders braced against the wall as if for support. "what do you mean?" she inquired slowly. barbara had not finished dressing. indeed, she was in the undignified attitude of sitting on one side of the bed putting on her stockings. nevertheless, she gazed at eugenia squarely. "i mean just what i said," she answered. "that is, of course, i don't know the name or the age or the identity of the man i saw by accident in the woods last night. but i realize that he must be the same person you have been concealing ever since you took this house. naturally he must grow weary of the long confinement and be obliged to go outdoors now and then at night." eugenia had not replied, so barbara went on thinking aloud. "or else some one may have been coming to the house with a message for the person in hiding. of course, i don't know whether your refugee is a man or woman. but whoever he or she may be, goodness knows, i'll be grateful enough when the escape is over and this house left behind!" eugenia's face whitened at the younger girl's words. nevertheless, she again turned as if she meant to leave the room without an answer. barbara was too quick for her. she took hold of both her shoulders and pulled her gently around. "i would rather you would say something, gene. i have been doing all the talking ever since i arrived. one minute i can't decide whether i ought to try and find out who this person is you have in hiding, or what your reason is. then i wonder if it is best i should leave you alone? but please, please don't run any risks. you know that if you are defying the german authorities and are found out, what your punishment may be. what could _i_ possibly do to help you? i feel so powerless. i can't tell you how i have longed to confide my suspicion to dick thornton or the girls and ask their advice. but i have kept absolutely silent." "thank you," eugenia said, and then waited another moment. "sit down, please, barbara," she added. "i suppose it is only fair that i offer you some explanation. you have been so good." barbara did as she was requested. but eugenia continued to stand. her level, dark brows were drawn close together and her face was pale. otherwise she looked entirely self-possessed, sure of herself and her position. "i am not going to tell you that i have any one in hiding here, barbara. if questions are ever asked of you, you are to know absolutely nothing. but i want you to understand that i appreciate perfectly the danger of what i have undertaken and have done it with my eyes open. if i am punished, well, at least i have always faced the possibility. but after today, dear, if things go as we hope, you need no longer worry over me. so far i feel pretty sure the germans in command of this part of the country have not suspected our house in the woods of being anything more than a shelter for defenseless belgian children. and really that has been my chief motive in all that i have done." barbara sighed. "god keep us through the day," she murmured, quoting a childish prayer. then eugenia went downstairs to her work and a short time later the younger girl followed her. barbara was to remain until after lunch. but at her friend's request she spent most of the time in the yard with the children and monsieur bebé. whatever went on inside the house neither she nor any of the others were to be allowed to know. as a special pleasure the children were to be permitted to eat their luncheon under an old tree in the one-time garden. this garden now held no flowers except two or three old rosebushes and overgrown shrubs. the heat of yesterday had returned and with it even more sultriness. there were heavy clouds overhead, but no immediate sign of rain. it was one of those days that are always peculiarly hard to endure. the air was heavy and languid with a kind of brooding stillness that comes before the storm. the nerves of everybody seemed to be on edge. monsieur bebé had lost his courage of yesterday and sat silent in his chair with his head resting in his hand. was he dreaming of provence before france was driven into war? or was he hearing again the cracking of rifles, the booming of cannon, all the noises of the past year of life in a trench? several times barbara did her best to distract his attention, but the french boy could do nothing more than try to be polite. it was evident that he hardly heard what she said to him. nicolete was too engaged with her duties in the house to offer companionship. nevertheless, she came back and forth into the yard. now and then she would stop for a moment to speak to monsieur reney, who was monsieur bebé only to barbara, who had so named him. nicolete was busy in arranging the outdoor luncheon for the children. for she it was who brought out the dishes and the chairs. only once did she have any assistance and then the maid from the kitchen helped her with the luncheon table. neither eugenia nor the woman whom they called "louise" was seen all morning. so to barbara fell the entire task of looking after the children. perhaps it was the weather, perhaps they too were vaguely conscious that something unusual was going on about them, for they were extremely difficult. not once, but half a dozen times, each child insisted upon going into the house to search for eugenia. she could not be busy for so long a time that she could not come out to them, they protested. this had never happened before. jan and bibo were particularly sulky, nevertheless barbara continued firm. jan had been made her especial charge. whatever happened he must be kept away from all knowledge of what was transpiring in the big house only a few yards off. this world is ever a double mask with the face of tragedy painted upon one side and of comedy upon the other. so often barbara thought of this during the long hours of the morning. sometimes she was whirling about with the children in a ring, singing at the top of her voice to keep their attention engaged. yet at the same moment her thoughts were all concentrated upon what was going on in the house with eugenia. whom had she in hiding all these weeks, risking her own liberty for his or her safety? and how was it possible that any human being could escape from belgium whom the germans wished to detain? yet not a carriage nor a human being approached the house from the front. of this barbara was absolutely certain. always when it was possible she had kept a watchful lookout. besides, there was jan who had appointed himself sentinel. the boy could not consciously have been expecting disaster. not a human being had given him a hint of what was to take place. yet he simply refused to play when the other children invited him. when barbara explained that eugenia insisted he remain out of the house, he made no effort toward disobedience. he merely took up a position as far away as possible, but one where he could still see the house and at the same time keep a lookout ahead. for his quiet gray eyes would study the landscape beyond him sometimes for five minutes, then he would turn his head and gaze toward the house. satisfied that he could discover nothing wrong there, he would again begin his former scrutiny. he was an interesting figure; barbara studied him whenever she had a chance. here was a child whom the war had not so far injured physically. although ill some weeks before he had since recovered. yet he would bear the scars that the war had made upon his spirit so long as he should live. bibo's lameness was as nothing to this boy's hurt. there was a look of abnormal gravity in his eyes, of an understanding of sorrows that a child of ten should know nothing of. he was fearful and frightened and yet there was something indomitable in the child's watching. he recalled the gallant army of children crusaders who, led by stephen of france, went forth to wrest jerusalem from the infidels. so their little sentinels must have waited wide-eyed and courageous, yet sick with dread, for the ravenous hosts to overpower them. another possibility worried barbara and the children all morning. there was a prospect that rain might come and so spoil their luncheon party. suppose they should be compelled to scamper for shelter just at the critical moment in eugenia's plans? the rain did not come. it must have been just a little after twelve o'clock when eugenia finally walked down the front steps into the yard. she did not look toward barbara, but her appearance was enough. whatever she had wished to accomplish was now over. although at the moment she was engaged in learning a new belgian game, barbara had to suggest that she be allowed to sit down for a time. eugenia might be able to look as calm as an inland lake, but she felt uncomfortably agitated. first eugenia spoke to monsieur bebé. then she walked down to where jan was standing. she said nothing to the boy, but put her arm on his shoulder. afterwards they walked back together toward the other children. but jan's expression had entirely changed. he was smiling now and his cheeks were happily flushed, yet he kept his hand tightly clutched in his friend's. soon after nicolete came out of the house with a great tray of sandwiches. there was real ham between some of them and peanut butter between the others. moreover, there was an enormous dish of baked potatoes and another of beans. for some reason the children did not understand, for it was neither sunday nor a saint's day, they were to have a feast. the table, which had been easy enough to arrange, since it was only a couple of boards laid upon carpenter's horses, was set in the middle of the garden, partly shaded by an old elm tree. the garden was just a few yards to the left of the house and in plain view of any one approaching. naturally eugenia took her place at the head of the table, with nicolete at the other end. barbara was on eugenia's right, with her eyes on the scene ahead. she could see the edge of the woods with the path that connected the house with the outside world. jan was next her with the same outlook upon the surroundings. it was jan who saw the two german officers approaching with a guard of eight soldiers behind them a few moments later. the boy had just lifted a sandwich to his lips when something in his rigid attitude first attracted barbara's attention. she then let her knife drop onto the table. the noise startled eugenia, for she too looked up. instantly barbara explained what was happening. "don't stir and please don't appear to be frightened before the children," eugenia ordered. "i must go and meet the officers, but i'll wait until they are nearer." so the german soldiers had a clear vision of eugenia and the children as they approached. the rough board table had no cover, but in the center was a bunch of wild flowers that the children had gathered in the neglected fields. in order to keep them from seeing too soon what must inevitably happen, eugenia started the singing of a belgian translation of the russian "prayer for peace." it was perhaps the song that came most from her heart at the moment, although she and her little companions had been trying to learn it for several weeks past. "god the all righteous one! man hath defied thee, yet to eternity sure standeth thy word; falsehood and wrong shall not tarry beside thee, give to us peace in our time, o lord!" then when the german officers were within a few yards of her, eugenia got up and walked quietly forward. she did not go alone though, because jan held on to her skirts so tightly that there was no possibility of tearing him loose. "will you wait a moment, please, until the children can be taken to another part of the yard?" eugenia asked quietly. "some of them are very young and will only be terrified and confused by our conversation. i think most of them are afraid of soldiers." there was no reproach in the girl's tone as she said this. but the sting was inevitably there. however, the older of the two officers bowed his head and nicolete led the reluctant children away. by this time barbara had placed herself at one side her friend next to little jan. and poor monsieur bebé, hearing the voices, had crept blindly forward to within a few feet of the little company. in the meantime the soldiers had divided: two of them stood before the front door and two had retired to the rear of the house. the other four guarded either side. "you are under arrest, fraulein," the german officer began. he was stern, but rigidly polite. "very well," eugenia answered. "in five minutes i can be ready to go with you. but tell me, please, of what i am accused." "you are accused of harboring a belgian spy, a colonel carton, who got back through the lines, disguised as a german soldier and into his wife's home in brussels. his effort was to obtain certain papers and information and then return to king albert and the british allies. we have reason to believe colonel carton is still in your house." the officer at this instant drew a pair of handcuffs from his pocket. naturally eugenia flinched, yet she held out her hands. "your intention is to search my house. you will, of course, do what you wish. but remember that i am an american citizen and under the protection of the united states flag." then one of the officers remained in the yard while the other led his soldiers into the house. ten, fifteen minutes passed. eugenia talked quietly to barbara. she begged her to ask permission of the hospital authorities to allow her to stay with the children. she told her where she might obtain the money for keeping up their expenses. some time before she had written a letter giving barbara her power of attorney. almost every detail had been arranged. of course, eugenia was frightened. she was not unlike other people, only that she had a stronger will and sometimes a finer determination. finally the german officer and his soldiers returned. "we can find no trace of colonel carton or his wife," the younger officer reported. "however, a servant from their household in brussels is here and i have reason to believe the two children of madame and colonel carton." still jan, who had never let go his hold on eugenia, did not flinch. not once did he even glance up toward one of the german soldiers, nor give a sign that might betray him or his protector. "i am sorry, but you must go with us until the circumstances can be more thoroughly investigated," the older officer commanded. a short time afterwards eugenia went quietly away. one of the soldiers carried her suitcase. since she marched between them and showed no intention of giving trouble, the officer had taken off the handcuffs. evidently he meant to be as courteous as possible under the circumstances. moreover, eugenia's dignity was impressive. all through the interview barbara had felt her knees trembling so beneath her that she felt unable to stand. her hands were like ice and her cheeks on fire; moreover, there was a lump in her throat which made her totally unable to speak. nevertheless, she did speak whenever a question was asked of her, nor did she shed a tear until eugenia had gone. it was curious, but no one broke down, not even jan. he merely kept his hold on eugenia's skirt until she started to leave. then eugenia herself unloosed his hands. he had been on his knees before and he made no effort to get up afterwards. finally, when barbara lifted the boy in her arms she found it was because he was too weak to stand. chapter xiv _a month later_ dick thornton had taken lodgings in an old house in brussels in a once fashionable quarter of the city. he had a big reception room and a small room adjoining. recently nona and mildred had been coming in to have tea with him on their afternoons of leisure. they even dropped in occasionally in their daily walks. for in order to keep their health and spirits each red cross nurse, following the familiar rule, was given two hours off duty every afternoon. but barbara meade had never seen the quarters where dick lived. always she had pleaded some kind of an excuse in answer to his invitations, until finally he had proffered them no more. then for the past month she had been taking eugenia's place in her house in the woods. but this afternoon barbara had made an appointment to meet nona and mildred at dick's at four o'clock. half an hour before the time, dick came into the house with his arms full of flowers which he had purchased from a little old woman at the corner. she had become a great friend of his, for the flower business was a poor one in a city where people had no money even for food. so today dick had purchased bunches of wall flowers and others of columbine and larkspur. for the flowers grew in the old woman's own garden within a sheltered suburb of brussels. she must have grown them and sold them in order that she might still continue to sit in the same place. for so far as one could know she had no other reason for her industry. she appeared to be entirely alone and friendless. dick's sitting room was enormous, yet almost empty. the house had been deserted by its owners early in the war. they had then removed most of their belongings to london for safe keeping, soon after hostilities broke out. but dick opened wide a pair of french windows until the atmosphere of the room had grown cool and sweet. he then arranged his own flowers and set out his own tea table in a somewhat clumsy fashion, drawing four chairs conveniently near. they were the only four chairs in the room and very different in character. two of them were enormous armchairs upholstered in brussels tapestry, the other were two small wooden ones which had probably served for the servant's dining room. but dick was fairly well satisfied with the appearance of things, since empty grandeur is much more satisfying than tawdry quantity. afterwards dick disappeared to make an afternoon toilet. it had been such ages since he had worn anything but the most workaday clothes. now and then when he came in tired at night and discouraged with life from the sight of so much unnecessary sorrow, he used to slip into a smoking jacket for an hour or so. usually several american fellows dropped in later, young doctors or other men assisting with the belgian relief work. but today dick felt the occasion to be a more important one. barbara was coming on an errand of grave importance. yet one might as well meet the situation as cheerfully as possible. nothing was ever to be gained by unnecessary gloom. it still remained a task for dick to dress himself with one of his arms almost useless. at first it had been impossible and he had employed a man to help him. but men were needed for more strenuous labors these days than being another fellow's valet. so he had come to taking care of himself in a somewhat awkward fashion. the collar was his supreme difficulty, just as it frequently is with a man with two perfectly good arms. today, of course, because dick was in a hurry, his collar behaved in a worse manner than usual. the collar button had to be searched for under the bed for nearly five minutes, and then it did not seem to fit the button-hole of the shirt. finally dick sat down and began to smoke in an effort to soothe his nerves. mildred had promised to come along ahead of time to do whatever was needed. as there was nothing more, except to adjust his tiresome neckwear, he might as well wait in peace. but in the meantime dick read over the note from barbara in which she asked that the four of them might meet at his apartment. it was the one place where it was possible that their conversation be absolutely private. and what they had to discuss was a matter for gravest secrecy. although dick had previously arranged his hair with much care, while reading the note he thrust his hand through it until his locks rose in brown, byronic confusion. so when the first knock came at his sitting room door, convinced of his sister's arrival, dick strode to it, dangling his collar in his hand. his appearance was not strictly conventional. the girl at the door looked a little startled, then smiled and walked into the room without invitation. "i suppose i am first. i didn't mean to be," she explained. "but dr. mason came out to see one of the children and brought me back to town in the hospital motor car. so i got here sooner than i expected." "i am sorry. i thought you were mildred. i mean, i hoped you were mildred." dick laughed. "sounds polite, doesn't it, what i am trying to say? but the fact is, if you'll just take off your hat or your wrap, or your gloves, why, i'll disappear for half a minute and come back with a collar on." barbara nodded and her reluctant host disappeared. she was glad of a few moments to look around. it was almost homelike here in dick's quarters, and not since leaving the little "farmhouse with the blue front door" had she enjoyed the sensation of home. she certainly did not enjoy it at eugenia's big house, although she was now in full charge of the establishment. for there was always the sense of eugenia's loss and of the privations which she was enduring. barbara did throw her hat to one side and her coat and gloves. the freedom was pleasanter. then, since small persons have a penchant for large chairs and large persons for small ones, barbara seated herself in the most imposing chair in the room. not thinking of where she was, nor of what she was doing, she slipped one small foot under her, leaned her head against the upholstery and gazed critically around. they were going to have tea and she was glad of it. then she loved the presence of so many simple outdoor flowers. probably they had been purchased for nona's delectation, yet one could enjoy them just the same. besides, barbara was by this time convinced that she had entirely recovered from any jealousy where nona and dick were concerned. she had seen them very seldom in the past month. but this was not because she had any more feeling in regard to the situation. it was merely because she had more important matters to engage her attention. her talk with eugenia seemed to have cleared the emotional situation so far as she was concerned. now her interest in dick and nona was purely impersonal and friendly. yet barbara got up and strolled over to the tall french mantel. yes, there was a picture of nona on it. she had not been mistaken. certainly nona took an extremely pretty picture. her features were so regular and delicate. it was rather different if one chanced to be afflicted with a retroussé nose. still studying nona's photograph, barbara heard a slight noise behind her. there was dick with his collar yet dangling from his hand. "i say, which would you prefer, to talk to a man without a collar or to help him put one on? i am not going to lose all the chance i may have for seeing you in struggling with this dog-taked thing." the girl looked demure. then she indicated that dick might seat himself upon the lowest stool. the next moment he was entirely ship-shape, as barbara had also assisted in adjusting a new dark-red tie. it was of a flowing character, because dick wore the same black velvet coat in which he had appeared before barbara in new york city some eighteen months before. the coat was therefore not new. but dick may have had a suspicion that it was becoming, although men are not supposed to be interested in any such trivial concerns. however, barbara was aware of the becomingness and was sincerely glad to discover how well her former friend looked. certainly he had taken his share of the war's misfortunes in a courageous spirit. once she had not believed him capable of any ideal save a social one. barbara had returned to her tall chair and dick sat across from her on one of the wooden ones. the tea service stood between them, but of course they were waiting for the coming of the other two girls. although she had wished for her tea, barbara did not feel impatient over the delay at present. she was trying to make up her mind whether it would be wise to tell dick how glad she was of his cheerfulness before she began to speak of her own mission. for then there would be little opportunity for cheerfulness unless one of the others had better news to report than she had. so instead of beginning a conversation barbara sat in entire quiet, although gazing at her companion in an extremely friendly fashion. in the pause dick thornton suddenly thrust out his right hand and placed it lightly over barbara's hand, which chanced to be carelessly lying on the table. "i have something i'd like to tell you, barbara, before nona and mildred get here," he began. "it is a secret so far and perhaps i have no right to be so happy until things are settled. but i've every right----" the moment had come! the news that dick had to tell her she had been expecting. yet she had believed the announcement would first be made by nona. it was kind of dick to remember their former friendliness and to wish her to share his happiness so soon. but at this instant mildred and nona, without waiting to knock, opened the sitting room door and dick's confession was never made. chapter xv _powerless_ "but it is too dreadful for us to be able to do _nothing_," barbara commented. she looked dispirited and blinked resolutely at a small pocket handkerchief which lay folded in her lap. however, she had made up her mind not to cry, no matter what happened. after all, she was a woman and not a child, and eugenia would consider tears a most ineffective method of assistance. she had come to dick's apartment with every idea of being brave and had started off in that spirit. then dick's interrupted confession had been a trifle upsetting. moreover, she had hoped that dick or one of the girls would have good news to tell about eugenia, or at least be able to make a comforting suggestion. while she was thinking this, nona davis got up and began walking up and down the length of the room. "the situation is abominable!" she exclaimed. "to think of a splendid person like eugenia, who is so needed, shut up in a german prison! besides, she is an american girl! it simply makes my blood boil. i wish for a short time i were a man." nona's cheeks were a deep rose and her golden brown eyes were almost black from emotion. barbara thought she looked charming. but dick smiled upon the excited girl rather condescendingly. "do come and sit down, please, nona. i know it is your southern blood that makes you long to fight. but this isn't the time for it. after all, i am a man and i haven't been able to rescue eugenia. of course, you would be a more effective man than i can ever hope to be. but today let us try to face the situation quietly. it is the only way we can hope to accomplish anything." in order to take the edge off his words dick smiled. also he thrust a chair nearer his guest. barbara thought the other girl sat down somewhat meekly. never could she have taken a snubbing so gracefully. but then there was no disputing that nona had the sweeter disposition. then dick reseated himself by the tea table. after taking several papers out of his pocket he again looked over toward barbara. "i wish you would repeat to me, word for word, as nearly as you can, just what statement eugenia made to you when you were allowed to see her in prison," he demanded. his matter-of-fact tone and present cold manner entirely drove away barbara's weak leaning toward tears. "it was some time ago, but i'll try and repeat what gene said exactly as possible. she said we were not to be angry or embittered over her imprisonment, because she had defied the german authorities. she declared they had a perfect right to arrest her. for she _had_ been hiding a belgian soldier who would have been shot as a spy if he had been discovered. it was almost a miracle how he managed to escape. but they had been warned by a friend in brussels a few days before, that their house was at last suspected. actually madame carton and colonel carton both got away on the very day the german officers came for them. eugenia would not tell how they managed their escape. she said that wasn't my business, nor any one else's." as she repeated this speech, barbara looked so surprisingly firm that dick had to swallow a smile. unconsciously barbara was behaving like a phonograph record in reproducing the exact tones of the original speaker. "but if eugenia understood what she would have to face, whatever made her do such a mad thing? this colonel carton was absolutely nothing to her. when he returned to brussels he took his own risk. it is natural that the germans in command here in belgium should be enraged. he probably carried back much valuable information to the allies. goodness only knows how he ever succeeded in getting here, much less getting away!" dick protested, speaking as much to himself as his audience. then he pounded the table with his one good hand in his agitation. "eugenia was out of her senses. what excuse did she have for saving the man and his family? she is an american and is a guest of the country. she had no right to aid germany's enemies. besides, you girls always said that eugenia was the one of you who insisted that you remain absolutely neutral." with this final statement dick gazed reproachfully from one to the other of his audience. every day since eugenia's arrest he had gone about brussels seeking assistance and advice. he had seen the american minister, the american consul and nearly every member of the belgian relief committee. but in each case his answer had been the same. whatever was possible would be done to effect eugenia's release. but without doubt her behavior had placed her in a difficult position. but dick had not been alone in his pilgrimages. mildred, nona and barbara had been equally energetic. there was no person in authority in brussels possible to see whom they had not interviewed. but eugenia was still in prison and liable to remain there. however, she had not yet appeared for trial before the german military court. her friends were doing their best to have her set free before this time came. for once her sentence was declared, it would be more difficult to secure her pardon. eugenia insisted that there was nothing to do but plead guilty. and this might mean months or years of imprisonment! the three girls became more unhappy under dick's reasoning. it was so perfectly true that there seemed nothing for them to say. nevertheless, barbara flushed indignantly. dick always inspired her with a desire for argument. moreover, when it came to a point of defending eugenia, she would perish gladly in her cause. "i realize that eugenia's conduct does seem foolish. perhaps it was worse than that; perhaps she was wicked to do as she did," barbara added, no longer looking down at her handkerchief, but directly at dick thornton. eugenia, she appreciated, would not require to be absolved before the other girls. "just the same, i think there was something beautiful and inspiring in gene's act. she hasn't asked us to worry over her. she has declared all along that she was willing to take what was coming to her," barbara murmured, falling into slang with entire good faith. "her only defense is that both colonel carton and jan were desperately ill when madame carton made the appeal to her. if she had not gone to the house in the woods to take care of them, they must have been found out. then without a doubt colonel carton and perhaps madame carton would have been hung as spies." an uncomfortable lump was beginning to form in barbara's throat. for at the instant it seemed to her that dick thornton represented the whole tribunal of masculine wisdom and justice arrayed against a woman's sentiment. how was she to make him see eugenia's point of view? in spite of her best efforts barbara's eyes were filling with tears and her voice shaking. "gene says she never thought things out in detail, although she fully realized the risk she was running. all she decided was that jan and his little sister should not be made orphans if she could help it. she says that ever since she put her foot in belgium the cry of the children has been ringing in her ears. what had _they_ to do with this war and its horrors? if she could aid them in the smallest possible way, this was her work and her mission. 'inasmuch as ye have done it unto the least of these little ones, ye have done it unto me,'" barbara whispered, and then was unable to continue. but mildred had risen and was standing by her side as if she were a new witness for the defense. "i have written father the whole story, everything eugenia has done in connection with this entire case," mildred explained quietly. "and i have asked him to go to washington and see the secretary of state and the president if he thinks necessary. as soon as my letter arrived he answered it immediately, promising to do what i asked. then he told me to see eugenia and if it were possible to present his regards to her and to tell her to be of good courage. of course, he could not write all he meant, as his letter might be censored, but i think i understood father's point of view pretty well." because mildred thornton did not talk a great deal, what she said was usually respected. even dick looked somewhat subdued. "what do you suppose father really did mean, then, mill?" he queried. "i confess i am so troubled and so harassed over this business of eugenia that i am of little account. i keep regretting that she ever got herself and all of us into such unnecessary sorrow." mildred went over and laid her hands on dick's hair, which had again become rumpled through his agitation. "i don't believe father thinks eugenia's action was entirely unnecessary, dick, even if we must all suffer with her," mildred argued. "perhaps eugenia only did what any one of us would have done under the same circumstances, if we had possessed her courage and good sense. the belgians were perfectly innocent of offense in this war. colonel carton was risking his life and his honor. if eugenia could help him or his family----" "be quiet." it was nona's voice that spoke, although under her breath. at the same instant she held up a warning finger. there were persons passing in the hall outside their door. one could hear their footsteps distinctly. almost at once nona got up and approached the tea table. "let us have tea, won't you, please, dick?" she begged. "we are all tired and hungry and thirsty. besides, we are discouraged." she said this even more softly, although the sounds in the hall had ceased. doubtless the passersby were only other dwellers in the house. dick sighed with relief and gratitude. "what a satisfying person you are, nona! it would have been better, however, if you had made this suggestion half an hour ago." then he turned again toward mildred and barbara. "please don't think i can't see that there was something fine and quixotic in eugenia's conduct, even if i wish she had chosen differently," he added. "truth is, i have taken the situation more seriously than ever today because i have had bad news." nona davis had lifted the teapot in her hand to pour out the tea, but at these words she set it down hastily. mildred merely took a firmer hold on barbara's shoulder. "what is it, dick?" she demanded. this time dick got up and floundered about impatiently. "oh, it may be nothing and perhaps i should not have spoken of it. but the truth is, eugenia is ill. one of the physicians at the prison was considerate enough to let me know. he does not think the trouble serious and says eugenia insists she will be all right in a few days. just the same, eugenia has been through a lot. i don't want to be a croaker, but there was the strain of the long nursing of captain castaigne and then this business. one of you girls must go to her as soon as i can get you permission, if i ever can get it. which one of you shall it be?" from the depth of her big chair barbara answered in a somewhat weary but steadfast voice: "there is no question; eugenia and i have meant everything to each other lately, and----" "there is a question, barbara, and you must be sensible. in looking after eugenia's house you are doing everything you have strength for. i am sure you can't weigh a hundred pounds these days! ever since we came to belgium, it seems to me you have been growing tinier. after a while you may blow away," mildred declared. then she marched over and, removing the teapot from nona's hand, began pouring out the tea in a quiet and comforting fashion. "of course, eugenia is not well after a month of being in prison. why should any one of us expect her to be?" she announced. "here, dick, please pass this cup to barbara and your muffins. the poor child looks utterly fagged! we ought to have thought that she has come all the way in from the country and has probably been up since daylight. she is a very little woman to live in a shoe." gratefully and without further protest barbara drank her tea. she was more tired than she had dreamed and glad to be taken care of for even a short a time. how happy she was to have gotten over her former antagonism toward her friends. what right had she to be jealous and miserable because a beautiful experience had come to nona and dick? they were both her good friends. at this moment dick was whispering something to nona, while she smiled up toward him. there was no mistaking the expression in her eyes, barbara felt convinced. later on she would congratulate them, but not this afternoon; she was too tired. perhaps nona became conscious of the other girl's gaze, for she drew away from her companion. "by the way, barbara," she exclaimed, "there is something i have wished to tell you for several days! weeks ago when you told me you had discovered lieutenant hume a prisoner in brussels, i wrote him a note. it must have taken ages for my letter to get to him. anyhow, i received three or four lines from him the other day. i suppose it was all he was permitted to write. but he thanked me and said he was getting on pretty comfortably. certainly i could not but admire his courage." dick thornton frowned. "you don't mean, nona, that you wrote a letter to lieutenant hume in prison without his asking you. i didn't suppose you knew him sufficiently well." but before barbara could confess that the suggestion had come from her, mildred thornton interposed. "don't be absurd, dick. you are taking everything in a gloomy fashion this afternoon. i should have written lieutenant hume myself if nona had not. he is in hard luck, when a single line from the outside world is cheering. we must go now. please do your best to get me permission to visit eugenia. in the meantime i shall see what i can do. sorry we had to have such a dismal party tea. hope for better news next time." chapter xvi _louvain_ recently nona davis had begun to confess to herself that she might some day be able to like dick thornton more than an ordinary acquaintance. without doubt this idea had come to her gradually, for during their early acquaintance he had simply represented mildred's brother and barbara's especial friend. when she thought of him at all it had been chiefly in his relation to the other two girls. dick was good looking and agreeable, these were obvious facts. moreover, he had shown splendid grit and courage in his work for the poor and wounded in the present war. however, it was not until after their holiday visit together in paris that nona had reason to believe dick desired her intimate friendship. she had already left paris and was living at the little farmhouse in southern france when he wrote begging her to tell him the details of their life together which his sister, mildred, might forget. the request had struck nona as surprising. why had he not made the suggestion to barbara meade rather than to her? he and barbara had quarreled now and then before the trip to paris and while there, but in spite of this seemed to find each other's society more than ordinarily agreeable. moreover, dick probably owed his life to barbara. had she not rescued him from the bursting shell near their base hospital, or dick must have carried more than a useless arm as a record of his adventure. nevertheless, if dick and barbara had chosen for reasons of their own to be less intimate, nona could scarcely ask questions. neither did she see how she could refuse to write to dick thornton if he really wished it, since her letters were merely to keep him in closer touch with the four american red cross girls. dick wrote delightful letters and so did nona. besides, these were days when, in spite of its tragedies, life was brimming over with interests. the letters grew more frequent, more intimate, and finally dick spoke of his coming to belgium. but he proposed that his coming be kept a secret until the last moment, for there might be circumstances that would interfere. since his arrival nona had been frequently in his society. the fact that mildred was partly responsible for this, she did not realize. she only knew that barbara had persistently refused to join them in leisure hours. therefore she and dick and mildred were of necessity more often together; eugenia was entirely out of the situation. the fact that mildred purposely left her alone in her brother's society, nona never considered. whenever this had occurred, she simply regarded the circumstance as an accident. but nona naturally felt a closer bond between herself and dick since her confession of her own problem. moreover, she had taken his advice and sent a letter to her family lawyer in charleston. in this letter she demanded to be told everything that was known or could be found out in connection with her mother's history. but although a number of weeks had passed her letter had remained unanswered. three days after the interview in regard to eugenia in dick's apartment, nona received a hurried note. the note explained that dick thornton had been ordered to louvain to make an especial investigation for the belgian relief committee. he asked if nona could manage to make the trip with him. they would start early the next morning and return the same day. if it were possible for nona to be excused from her hospital work, he was particularly anxious to have her join him. ten minutes after the note arrived, nona was busy making the necessary plans. at the hospital there were no objections offered to her being given the day's holiday. for nona explained that she was convinced that it would be a wonderfully interesting experience to visit the ruined city and university of louvain. more than the other girls she had enjoyed their journeys from place to place in europe, when they were obliged to change their fields of work. even when these trips had not been taken under the pleasantest conditions her enthusiasm had been able to rise above the difficulties. when the war was over nona hoped before going home that it might be possible for her to travel over the continent. now and then she and mildred thornton had even spoken of this as a possibility in an idle fashion. for with nona such a discussion could be nothing but idle, as she had scarcely a dollar beyond what she was able to earn as a nurse. at ten o'clock on the chosen day dick called for her. as soon as she joined him in the hall of the hospital, nona recognized that dick had seldom looked so well. besides, he seemed somehow more vigorous and happier. in honor of the occasion he wore what appeared to be a new suit, although it had been purchased in london soon after his arrival a number of months before. after her first sensation of admiration nona suffered a tiny pang of envy. how satisfying it must be to have as much money as dick and mildred seemed to have! they were not extravagant and yet they never had to worry over small matters. more than this, it must be a great help through life to have so distinguished a father as judge thornton. whenever his name was mentioned abroad people had heard of him as a great international lawyer. sometimes nona wondered why mildred and dick should care for her friendship. the distinguished members of her family had belonged to generations that were now dead. but today, for many reasons, nona would particularly have liked to wear a different costume. for assuredly dick must be as tired of the one she had on as she was herself. it was the same black dress that she had bought in paris last spring and been compelled to use for best ever since. true, nona had managed to run out the evening before to one of brussels' millinery shops, where she purchased a small black turban. before the coming of the german military hosts to belgium, brussels was regarded as the small sister of paris in matters of fashion. since then, of course, the city had but little heart for frivolity. however, nona felt fairly well satisfied with her purchase. moreover, she was pleased to discern that dick thornton's eyes rested upon it with immediate satisfaction. it is true that a man more often observes a woman's hat than any part of her costume. in walking on the street you may make this discovery for yourself. a man or boy looks first at a girl's face, then if this pleases him he slowly studies her costume and figure. frequently a woman or girl glances first at the toilette, and then if displeased never cares to look beyond for the personality. however, nona had but little reason for being dissatisfied with her own appearance. she was one of the few fortunate persons who have a grace and beauty of coloring that is not dependent upon clothes. clothes help, of course, under all circumstances, yet she could manage to be beautiful in shabby ones. moreover, the black dress was only slightly worn and her white crepe waist had been freshly washed and pressed. before she arrived at the station du nord with her companion, nona had the good sense to cease to consider her apparel. for since belgium was a land of mourning, poverty was the most fitting dress. the land between brussels and louvain was once an agricultural district. since belgium had been conquered and possessed by the germans, they had made every effort to resow and harvest many of the fields. but the neighborhood of louvain was still a place of desolation. as their train carried them farther along on their journey, nona decided that she had never seen anything like the countryside in all her experience as a war nurse. in certain parts of france wide areas had been destroyed, but not far away one would often find other districts untouched by fire or sword. dick and nona talked in a desultory fashion as they journeyed toward the famous old university town. one felt as if louvain was already a city of the past. within its suburbs there were many small ruined homes, looking as if a giant had ruthlessly pushed over whole rows of dolls' houses. for louvain was formerly one of the lace-making centers of belgium, and in these small houses dark-eyed women and girls once worked long hours at their trade. before their arrival dick decided that he must first attend to his business in louvain. afterwards they would feel freer to prowl about and investigate the ruins of the university. it would not be necessary to hurry then, as there would be no reason to return to brussels until after dark. dick's pilgrimage to louvain had been inspired by the desire to discover a family of belgians supposedly starving in one of the city's wrecked homes. the father was known to have been killed at the sacking of louvain. yet in some amazing fashion the mother and children had continued to exist for nearly a year without money and almost without food. the american relief committee, learning their need, had despatched dick to see what could be done for them. just what the character of the place he was to seek, nor the conditions surrounding it, the young man did not know. therefore, he considered it wiser for nona to wait for him. so he led her into the interior of the ancient church of st. pierre, where she was to remain until his return. the church had been only slightly injured by the burning of the city. as a matter of fact, nona was glad to be allowed to rest there peacefully for a time. although she was an excellent nurse, she was not so successful in making friends with unfortunate people as the other three red cross girls. so she feared that dick might consider her more of a drawback than a help to him in his work. the girl was frank enough to confess to herself that she wished to make a good impression. an old church is ever a citadel of dreams. yet nona had not the faintest intention of letting her imagination wander into unbounded realms when she first found a seat in the semi-darkness. simply from curiosity she had gone into one of the chapels behind the high altar. here she discovered five paintings, depicting the life and death of the blessed margaret of louvain, the patron saint of domestic servants. at first nona was simply amused and interested, for it had not occurred to her that domestic servants had a saint of their own. then without realizing it she fell to thinking of her own old home in charleston, south carolina, and of the southern "mammy," who had been more than her own mother to her. it was strange that her lawyer in charleston had not yet answered her letter. perhaps she would ask dick his opinion again. however, nona felt a curious shrinking from this idea. for if dick was beginning to feel interested in her, surely the mystery of her mother's history must influence him against her. at the same instant the girl's cheeks grew hot with embarrassment. then she deliberately struggled to discover a different train of thought. but for some reason, no matter along what road her thoughts set out, they had a curious fashion of including dick before the end was reached. so at last nona gave up and let her imagination have its will. when he came back an hour after their usual luncheon time, dick found her not in the least impatient. she insisted that she had enjoyed herself, and her face and manner gave proof of it. but dick was tired and not so cheerful as he had been earlier in the day. his work was over temporarily, but he had found a most depressing state of things among his poor people. moreover, dick was hungry, when a masculine person is always difficult. they discovered a little restaurant existing in a half-hearted fashion near the university. after a leisurely meal, it must have been past three o'clock when finally the two friends made their way into the university grounds. the buildings were not all entirely destroyed by the german bombardment, as the newspapers gave us to understand after the fall of liege. possibly many of them can be restored when the present war is over. up and down the rue de namur the young americans wandered, first investigating the ruins of the handsome gothic halles. the library is perhaps the most complete wreck, and it was one of the most valuable libraries in europe. for it contained many priceless manuscripts gathered together by the old monks, who were once teachers in this most famous catholic university in europe. the university of louvain was founded in the fifteenth century by pope martin v, and only a little over a year ago sheltered eighteen hundred students. but they have disappeared even as the bricks and mortar of the centuries have been brought to confusion. finally after nearly two hours of sightseeing dick and nona confessed to each other that they were too weary to feel any further interest in their surroundings. moreover, they were obliged to rest before returning to the railroad station. nothing could be more romantic than the spot they chose. with a half tumbled down wall for a background and a tall tree for a screen, a small green bench lingered serenely. it was as comfortable and undisturbed as though no destruction had raged about it. with a sigh of relief dick dropped down beside his companion. "if you don't mind, i'd rather not speak for five entire minutes," he suggested. "afterwards perhaps i may tell you something about which i have been thinking more or less all day. but i am not yet convinced that i ought to mention it to you, though with all my heart i wish to know what you think and feel upon the subject." in reply nona only nodded agreement. then she folded her hands in her lap and sat gazing quietly at the unique scene about them. in a little while twilight would fall. the atmosphere was already a pale violet and over the massed ruins of the ancient buildings the sun was declining peacefully. except for the girl and her companion the neighborhood was deserted, not a man, woman or child, not even a dog could be discovered in the nearby streets. chapter xvii "_sisters under the skin_" after a little while the silence between the girl and man grew self conscious. both of them seemed to recognize this at the same moment, and dick turned apologetically toward his companion. "i am sorry to continue so stupid," he explained, "but i have been thinking something over for the nine hundred and ninety-ninth time." in spite of the coolness of the october afternoon dick now took off his hat and in a boyish fashion ran his fingers through his hair. immediately the curly pompadour he so detested arose, while under his dark skin the color was rushing in warm waves. "i say, nona," he began in an awkward fashion, his charming manners entirely deserting him, "has it ever struck you that i have had something very much at heart for the past few months, something i have not been able to mention? it has seemed to me as if the whole world must know of it, although i have never spoken a word. yet even mildred has appeared totally blind. of course there was a reason once why i should keep my dream to myself, but lately that reason no longer exists." then dick laughed unexpectedly. "here i am talking like a school-boy who does not know his lesson! i don't suppose you have the faintest idea of what i am trying to say? wonder if you have ever guessed my secret, nona?" dick had swung himself around on the bench so that he might be able to gaze more directly at his companion. but nona davis' head was for the instant in profile. just then she preferred not to catch dick's glance. her own cheeks were delicately flushed and indeed the world had acquired a new fragrance. yet oddly nona wished to hug her emotion to herself. there is a moment when the spirit of romance appears to every girl in some lovely guise. now nona davis felt that no moment and no scene could be more picturesque than her own. dick thornton was ideally handsome; moreover, the fact that one of his arms was now useless only added to his value. for was not dick a soldier of peace rather than of war, yet one who had made the same sacrifice? and he had given himself for a cause that was not his own. "no, i have not guessed, dick," nona replied an instant later. "how could i? if you have a secret you have certainly not betrayed yourself. besides, if i had been able to discover what you had in mind, i should not have allowed myself to know. no one has the right to interpret another person's thoughts." nona made this speech with entire innocence, but she was to recall the last phrase within a few moments. "well, i'll start off with a piece of news i am sure you will be pleased to hear," dick began. "i wanted to tell barbara first, but we were interrupted the other afternoon. it is only that i think i am to have better luck with this lame arm of mine than i deserve. when i was in paris the surgeons told me to leave it alone, that i stood a chance of being able to use it later on. so i tried to forget the whole matter. then one day several weeks ago without thinking i discovered that i could use my arm the least bit. of course, it is by no means well, but each day the arm grows stronger----" with this news nona stretched out her hand toward her companion. but dick did not see her, as he chanced to be gazing at his afflicted arm in the half tender, half apologetic fashion in which one surveys a backward child. "the doctors i have seen since i made the discovery say my arm will be as good as new in another few months," dick went on. "i have only to have it massaged daily and wait for the vigor to come back. so i may be able to amount to a little something in the world after all. perhaps a man with a lot of brains may manage to get along with no arms, but i'm afraid _i_ require the full amount." by nature nona davis was inclined to be serious. therefore she could never understand the fashion in which barbara and dick were able to jest over their deeper emotions. her yellow-brown eyes were serious now. "i am sure _i_ have never doubted your future for a moment, dick. it sounds ridiculous to hear you make a speech like that. i am sure your father is a distinguished man, yet i feel sure you will be a greater one some day." for half a moment dick smiled upon his companion. "you are an optimist, nona, but just the same i am tremendously grateful to you." then in a surprising fashion his gay spirits suddenly deserted him. for he frowned moodily toward the purple and rose colored sky on the far western side of the horizon. the sun was by this time about to retire and the colors in the evening sky were merely the garments she had cast off in passing. "i wish you could persuade barbara meade to share that idea of yours, nona?" dick continued a moment later. "if you could you would be doing me an immense service." "barbara?" nona repeated her friend's name dully. she was so far away from any thought of her at the time that it was difficult to readjust her point of view. "what is it you wish me to persuade barbara to believe?" she demanded the next instant. for in her surprise she had forgotten her own remark. "oh, that i am worthy of bearing my father's name and that there is a chance i may not turn out a hopeless good-for-nothing," dick went on, with a scarcely concealed bitterness in his voice. "two years ago when i first met barbara i suppose i was only a society fellow, but really i was not so bad as i painted myself. fact is, i rather enjoyed arousing mildred's little western friend in the early days. well, i accomplished my purpose with a vengeance, for barbara has never had an ounce of respect for me. even if you and mildred have never guessed how much i care for her, the fact has been plain enough to barbara. what other reason could she have, except to spare me humiliation, for refusing to have anything to do with me since i came to brussels? but you have understood the situation better than you confess, nona. be sure that i appreciate your kindness immensely." still nona made no reply. however, as dick had been holding his emotions in check for many weeks, he was glad now to have a chance to let them overflow. "i appreciated that you understood when i first asked you to write me, after you left paris," the young man continued. "your letters meant so much to me, for they used to tell me so many things of barbara and your life together in the little french farmhouse." interrupting himself, dick glanced at his watch and then at his companion. "you look tired, nona, and i am sorry, but i expect we must hurry if we are to get to the station in time for the six o'clock train to brussels. you have been wonderfully patient with me this afternoon and i hope not too bored. perhaps i should have kept all this to myself, but at last it has overflowed. i shall never refer to the matter again and shall be grateful if you do not mention it." dick held out his right hand to help his companion arise. but for another instant nona did not stir. neither did she glance upward. her eyes had dropped to her lap and were evidently fastened upon her slender hands, which she held lightly clasped together. possibly she had become a shade paler, but not by a flicker of an eyelash did she betray that her house of cards had suddenly fallen. the next moment she gave her hand to dick and got up. "i am not tired, so let us walk on quickly if you think best. i am going to be honest and tell you, dick, that i have never dreamed you were seriously interested in barbara until this hour. i knew you were friends at one time and that barbara had done a beautiful thing for you. but i thought you had probably quarreled, or that you did not find each other so interesting as you had at first." the girl was walking along swiftly as she talked. her delicate chin was lifted a little higher than usual and because of her pallor her lips showed a deeper crimson. she was a lovely height and slender and graceful, but beyond everything else she had the air of perfect breeding. dick's own train of thought was diverted for a moment by a glance at her. "after all, it is not an impossibility, nona davis' mother may turn out a foreign princess," he thought, and then smiled. for dick was a typical american man and to him a mystery in one's family was ridiculous when it was not unpleasant. on the train returning to brussels neither he nor his companion cared to talk a great deal. indeed, nona frankly explained that there was something she wished to think about, and if dick did not mind, would he please leave her alone. so he was satisfied to continue sympathetically silent. he had unloosed certain thoughts of his own which were not so easy to chain up again. however, they still had a half hour before their arrival in brussels when nona unexpectedly returned to their former subject of conversation. "you asked me never to refer to your confession, dick, and i won't again after today. but first i must tell you something. then if you'll forgive me i want to offer you a piece of advice. i know it is an ungrateful present, but you'll listen, won't you?" nona pleaded. dick's brown eyes were very friendly. "i'll listen to whatever you wish to tell me forever and ever," he insisted. "for there was never quite so kind an audience as you have been to me!" the girl was glad of the flickering lights in the railroad carriage, when she spoke again. "it is only that i have been thinking of you and barbara ever since we left louvain," she added. "i told you i was surprised at the news. but now i think it was stupid of me. what i want is to ask you to tell barbara what you have confided to me this afternoon. i understand that when you were uncertain about your arm, you may have felt that a drawback. now you have every right to believe in your recovery and"--nona hesitated and smiled directly into dick's somber brown eyes--"oh, well, it is only fair that barbara be allowed the same information that i have received under the circumstances!" at this moment it was dick who would not be humorous. "i suppose you think i ought to give barbara the satisfaction of telling me what she really thinks of me. but i am afraid i am not willing to amuse her to that extent." nona shook her head. "that wasn't worthy of you, dick; i know you did not mean it. i am not going to give up. i want you to promise me that whenever the chance comes you will let barbara have some idea of your feeling for her." this time nona held both her hands tight together. "i can't explain to you, dick, so please don't ask me why," she continued. "but i have been thinking that there may be another reason why barbara has seemed less friendly with you since your arrival in brussels. girls sometimes get strange ideas in their minds. but there we are coming into brussels. thank you for my day in louvain, i shall not forget it!" chapter xviii _difficulties_ perhaps it was due to nona davis' advice, or perhaps to dick thornton's own judgment, that he decided to make his position clear to barbara. he had no thought of her returning his liking; nevertheless, a confession appeared the more manly and straightforward. but beginning the next day's events moved ahead so swiftly that there was never a chance for dick to carry out his intention. by noon a message was sent him by his sister mildred. she explained that soon after breakfast she had been summoned to the german prison for a consultation in regard to eugenia peabody. she found the prison officers both embarrassed and annoyed. for the young american woman whom they had been compelled to arrest had become dangerously ill. they had not been prepared for such a contingency. she had been locked up in what had formerly served as an ordinary jail in brussels and there were no accommodations for seriously ill persons. they could not determine what should be done. it was extremely awkward to have their prison doctor declare the prisoner a victim of typhoid fever, and to have the physician sent from the american relief committee confirm his opinion. suppose this miss peabody should be so inconsiderate as to die? the fact might arouse international complications and would certainly precipitate unpleasant discussion. the young woman had been kept a prisoner for something over a month without a trial, but even in this time important pressure had been exerted for her release. because she had been an american red cross nurse, naturally all red cross societies were interested. moreover, she was said to be a member of an old and prominent new england family, who would make themselves heard in her behalf. then as this miss peabody was herself wealthy and had been using her money for the benefit of the belgian children, what might not be said in her defense? there was a chance that the german government would be accused of resenting her care of the belgian children. in order to show their good feeling, mildred had been permitted to visit eugenia. she found her friend in a small room like a cell. it was of stone with only one window, a stool and a cot bed. but whatever eugenia must have suffered for her breach of faith, she was now past being disturbed by mental unhappiness. for an hour mildred sat beside her friend trying to arouse her. but eugenia gave no sign of recognition. she did not seem to be enduring pain, but was in a stupor from fever. mildred felt unhappy and helpless. there was but little chance of her friend's recovery if she remained without the right care. moreover, the american red cross girls owed it to one another to keep together through good and evil fortunes. "what would eugenia have done for one of them under the same circumstances?" mildred tried her best to decide. she implored the prison authorities to allow her to remain and care for her friend. but they refused. it was not that they were unwilling for their prisoner to be properly looked after. it was that there were no arrangements whereby it was practical for mildred thornton to continue at the prison. she could come each day and stay for a time with her friend. and this was, of course, a surprising concession. so after mildred returned to her own quarters she had sent a note of explanation to her brother. then began the most anxious week that the american red cross girls had endured since their arrival in europe. before now anxiety had harassed one or two of them at a time. now they were all equally concerned. eugenia did not grow better. from day to day the report of her condition became worse. mildred thornton was the only one of the three girls ever allowed to enter eugenia's room at the prison. however, nona and barbara hovered about the neighborhood like restless ghosts. indeed, they now appeared as deeply attached to each other as in the early days of their acquaintance. nor was dick thornton much less anxious. he had always liked and admired eugenia. although he disapproved her action in regard to colonel carton, it was not possible wholly to object to it. one had to have a sneaking sense of appreciation for a girl or man who would risk so much for an entire stranger. however, interest in eugenia's condition was not confined to her few friends. in a little while her case became the most talked of in brussels among the americans and their acquaintances. then the news of eugenia's arrest and the reason for it appeared in the american daily papers together with the account of her critical illness. afterwards these facts were copied in the newspapers of england, france and russia. eugenia became an international figure. now and then barbara tried to smile, thinking how eugenia would have resented her notoriety had she been aware of it. but the idea did not create much mirth. it was so far from amusing to picture one's friend at the point of death, shut up in a tiny room, with only such crude care as the prison physician and nurse could give her. the situation was unendurable; nevertheless, like a great many other situations about which one says this _same_ thing, it had to be endured. the german officials in command of the city of brussels assuredly grew weary of visits from white-faced american girls and their friends, all bent upon the same quest. was it not possible that eugenia be removed to a hospital or to her own home until she recovered? the answer remained the same. much as the situation was to be deplored, one could not surrender a prisoner because of ill health. discipline must be enforced. then a day came when mildred and dick thornton were granted an unexpected interview with the american minister in brussels. they had seen him several times before, but on this occasion it was the minister who sent for them. he had previously been kind and interested in eugenia's case, but so far his good will had not availed in her behalf. he could only offer his good will, because it was not possible to demand the prisoner's liberation when she had frankly confessed her offense against the german administration. yet as soon as they were permitted to enter the study where the minister was seated at his desk, mildred thornton had her first moment of hopefulness. for mr. whitlock had become her friend since this trouble began and his expression indicated good news. "there was no use going into particulars," he declared, "but some days before he had received certain letters from washington. it appeared that judge thornton had been to washington in eugenia's behalf, according to his daughter's request, where he must have interviewed persons of importance." whatever took place the american minister now announced that he had placed judge thornton's communications before the proper german officials. whether they were influenced by these letters, or whether they concluded that there was more to be lost than gained by detaining their prisoner under the present conditions, it is impossible to say. the important fact was that eugenia might at last be moved to her own house. there she was to be allowed to stay under guard until such time as she could safely leave the country. she would then be conducted to the border line of holland and allowed to depart. but eugenia peabody was never again to set foot within a german country during the course of the present war. if she should enter it she would immediately become liable to arrest. so in spite of the possible danger eugenia was immediately removed to her own house in the woods, the house supposedly inhabited by a ghost. but instead of ghosts it was now haunted by the other three red cross girls, all of whom insisted upon sharing the labor of caring for eugenia and looking after her home. yet after all it was on barbara meade that the largest share of the burden fell. for the children had grown accustomed to her since their first friend's departure. then by a freak of chance eugenia seemed to wish barbara near her the greater part of the time. she was not conscious, so her desire was only an eccentricity of illness. nevertheless, barbara naturally tried to be with her friend whenever it was humanly possible. so it is easy to see why dick thornton found no opportunity to confide to barbara the dream that lay so near his heart. he saw her now and then, of course, in his own frequent visits to the household, but seldom alone. occasionally, when for a moment he had a chance for a quiet word with her, dick was not willing to intrude his own desires. barbara looked so worn and fragile these days. the roundness had gone from her cheeks as well as their color, her eyes and lips rarely smiled. it would only trouble her further to have him cast his burden upon her. for barbara would, of course, be sorry to cause him unhappiness. so dick decided to wait until serener times. one afternoon, however, the opportunity for entrusting one of his secrets arrived. for the past three days eugenia had been growing continuously weaker. the crisis of her disease had passed and her fever was not so high. but her weakness had become a more dangerous symptom. about four o'clock dick drove out to the house in the woods with dr. mason, who was one of the physicians devoting himself to eugenia's case. he did not go indoors, but asked that one of the three american red cross girls be sent out to speak to him. it was a cold afternoon, yet the sun was shining and dick felt that the fresh air would be of benefit. no matter which of the three girls was free to join him, they could walk up and down in the yard for a few minutes. the suspense of waiting for dr. mason's verdict would be less severe outdoors than shut up inside. but although dick walked up and down the front porch for quite ten minutes, no one appeared. either dr. mason had forgotten to deliver his message or else the girls were too busy or too nervous to leave the house. dick finally grew weary of the veranda as a place for a promenade. a little later some one would be sure to come out to him, and in the meantime he would walk a short distance into the woods. a few yards along the path the young man stumbled across barbara. she was wearing her gray blue nursing cape and was sitting upon a log. she looked so tiny and was huddled so close that dick somehow thought of a little gray squirrel. barbara was too engrossed in her thoughts to hear him until he was almost upon her. then dick grew frightened, because instead of speaking she jumped to her feet and put up her hand to her throat as if she were choking. it did not occur to dick that she was terrified. he did not dream that she had run away from the house because she dared not wait to hear dr. mason's decision in regard to eugenia. now, of course, she thought him sent to her with a message. and the worst of it was dick did not say a word. he simply stared at her, mute and sorrowful, because gay little bab had become such a pathetic figure on this november afternoon. dick's silence could mean but one thing to the girl. she made a little fluttering sound, wavered, and the next moment dick was holding her upright on her feet with both his arms. at this same instant barbara forgot both eugenia and herself. she had felt the world growing dark before her eyes a moment before. now a miracle brought her back to her senses. she drew herself away at once and stood upright. then placed both her hands on dick thornton's two arms. "dick," she said in an awed tone, "didn't you use _both_ your arms just now, when you kept me from falling?" her companion nodded. "i have been meaning to tell you, barbara, but you have been too busy with other things. my arm has been growing stronger each day, but i didn't know myself until this minute that i could use the lame one as easily as the good. i suppose because i was frightened about you, i forgot my own weakness." then while barbara was gazing at her friend in silence, but with her eyes expressing her joy in his news, mildred thornton came running along the path toward them. "dr. mason says eugenia is much better this afternoon. he has the greatest hopes of her," she cried, while still several yards away. "gene recognized nona and asked for something to eat. nona says she even objected to the way in which she gave her medicine, so i suppose we have the old gene back again. come with me, barbara dear, dr. mason says we may both speak to her. afterwards she is to be left alone to go to sleep and i shall have to try to keep the children quiet. you must see if you can get jan away from her door. the boy has not moved from there since six o'clock this morning." then mildred condescended to recognize her brother. but after kissing him hurriedly, she put her arm about barbara's waist and both girls fled back to the house. later, dick returned to town without seeing either one of them again that afternoon. chapter xix _en route_ barbara meade was chosen as the suitable one of the three girls to accompany eugenia out of belgium. there were a number of reasons for this decision, but the most important was that her friends agreed she was most in need of a change. another point was that eugenia appeared to prefer to have her. but the journey could not be expected to be an altogether pleasant one. eugenia was still ill enough to be a responsibility, and, moreover, the german authorities did not hesitate to express their wish to be rid of her as soon as possible. it was for this reason that the trip was planned as soon as it was in the least feasible. toward the middle of december the preparations for departure were finally concluded. it was arranged that nona davis and mildred thornton should remain in charge of eugenia's house in the woods for a time. for the children must continue being cared for. therefore, the american hospital in brussels had agreed temporarily to dispense with their services. later on perhaps it might be possible to make a more definite arrangement. but at present nona and mildred were both pleased to have a change in their work. besides, this change afforded them the chance to stay on with their friends until the actual time of their leave-taking. neither of the four girls ever forgot the final moment of farewell. since daylight they had talked about everything else under the sun except the fact that they might not meet again for many months. for under the circumstances naturally their future plans were indefinite. barbara and eugenia had been informed that they would be escorted to the frontiers of holland. once within the neutral state no further observation would be made of them and they could go where they chose. they had determined to cross at once to england and then, lingering only long enough for eugenia to rest, to travel by slow stages to southern france. once there, they were once more to take refuge in the little "farmhouse with the blue front door." for in the midst of eugenia's illness a letter had arrived from madame castaigne. in it she had demanded that miss peabody be removed at once from a country at present overrun by barbarians. in her opinion, the american red cross girls should never have departed from the protection of her beloved france. whenever it was possible the farmhouse was at their disposal. moreover, madame castaigne suffered for their companionship. for she and françois had been entirely alone for months. captain castaigne was away in another part of the country with his regiment. so it had been both eugenia's and barbara's fancy to go back for a time to the little house they had both loved. when eugenia had entirely recovered her health, they could then decide on the next step. at eugenia's request no one of their many friends in brussels came out to say good-bye on the last day. for her own sake and the happiness of the children she wished her departure to be as quiet as possible. she and barbara were therefore ready and waiting by noon, when the german officer arrived who was to take them to the border line. neither of the girls had been informed who this man might be, nor what his character and rank. personally, barbara felt a considerable anxiety. so much of the comfort of the first of their journey would depend on his courtesy. then there was the chance that eugenia might be less strong than they hoped and fall ill again along the way. yet eugenia herself seemed to have no qualms upon the subject. her one desire appeared to be to get away, to return to the country she had wilfully turned her back upon. for it had been chiefly due to eugenia's influence that the american red cross girls had left france to begin a new service in belgium. finally, when the german officer arrived, nona, mildred and barbara were equally discouraged by his manner and appearance. in the first place, he was a man of a rough and surly exterior. he was only a sergeant, with an overbearing and insolent method of speaking. indeed, he made no pretence of treating eugenia in any way except as an intruder who had come dangerously near being a traitor to his government. therefore, he had nothing but scorn and dislike of her. he would have chosen to travel with his prisoner in handcuffs, but since this had been forbidden she should be allowed no other consideration. so nona and mildred had to kiss their friends good-bye with the german sergeant staring at them disdainfully. then before they realized what was taking place they beheld eugenia and barbara being marched down the path toward a car which was to take them to their train. eugenia could scarcely keep up with the rapid pace demanded of her. she looked very ill and fragile and barbara very tiny to have her clinging for support to her arm. neither mildred nor nona could see distinctly at the last. afterwards they remembered that eugenia and bab had both waved their hands just as the motor car plunged ahead down the narrow path through the woods. they had promised to write as soon as it was possible to get a letter through the lines. but there was a chance that their mail must first be sent to the united states and then have to recross the ocean. naturally the two girls who had been left behind were deeply depressed. yet they had little time for reflection. for eugenia had asked that the children be given a feast as soon as she was safely out of the way. moreover, there was nicolete dissolved in tears! she had wished to accompany her friend, but on account of monsieur bebé's helplessness had been persuaded to remain behind. work is ever the solace of sorrow, as mildred and nona both discovered ten minutes after their parting from the other two red cross girls. but eugenia and barbara had no such immediate consolation. half a dozen times in the next few hours barbara greatly desired to start a war on her own account. yet in spite of her somewhat fiery temperament she could say and do nothing. it was not on her own account that she was so angry, but for the sake of her friend. for notwithstanding her apparent weakness, eugenia was forced to travel in a train so crowded that she started upon her journey standing up. barbara's protest against this as an impossibility availed nothing. but a few moments later a belgian woman took compassion upon them. she was old but sturdy and determined and eugenia's refusal to occupy her place she would not consider. moreover, the girl had by this time reached such a condition that she must either sit down or fall. though desiring her to be as wretched as possible, even her guard appreciated this fact. afterwards barbara decided that she had never gone through more trying hours than those she endured on their way into holland. eugenia scarcely spoke a dozen words. indeed, she appeared happily unconscious of a great deal of the insolence leveled at her. but barbara missed nothing. the sergeant's every glance at eugenia was an insult, whenever he spoke to her it was with a growl. perhaps his task of driving an american girl out of a once friendly country was such a disagreeable one that no one except a bear would have wished to undertake it. however, both barbara and eugenia were willing exiles. the moment when the girls realized that their feet were upon dutch soil was the happiest they had spent in many weeks. for here at last their guard said good-bye to them. at least, though he used no words, his behavior had the effect of a good-bye. what he actually did was to deposit them upon the platform of a railroad station, then with a grunt of disfavor turn and stride away. but the girls both knew that the next train on which they were to travel would run through the peaceful dutch country. by night they arrived at a dutch port. in spite of the peril of floating mines and submarines the holland passenger boats were still making their nightly journeys to the english coast. naturally there were but few passengers aboard, as no one was crossing for pleasure. but tonight there were a small number of business men and a few women. at eight o'clock in the evening their boat sailed, and immediately after barbara and eugenia went to bed. food was brought to their stateroom, but they were too weary and too excited to eat, so it was scarcely nine o'clock when they were both sound asleep. of course they appreciated the possible danger of their crossing. but as a matter of fact neither barbara nor eugenia gave the idea five minutes' thought. when one has lived in the midst of war's tragedies and terrors, one no longer worries over _possible_ misfortunes. there is time enough when the blow falls. therefore, at midnight the two friends were peacefully sleeping, when they were awakened by an extraordinary sensation and then a tumultuous noise. suddenly their little steamer had come to an abrupt halt in mid-sea. there was no warning, no gradual slowing down. one moment they had been traveling at full speed, the next they were at a complete standstill. then there began a tremendous rushing about on the deck above the floor where the two american red cross girls had their berths. soon after a heavy splash followed as if something had been dropped into the sea. although they were both awakened with the first reversal of the boat's engines, neither of the girls spoke until after the noise subsided. then it was eugenia. "something extraordinary has happened, bab dear," she said quietly. "i think you had best go and see what it is. i have a feeling that perhaps our boat is going to sink. but there has been no explosion so far!" eugenia was extraordinarily calm, almost passive. one may not believe this state of mind to be possible, but wait until you have had just such a personal experience with danger. barbara's answer was to scramble quickly out of the upper berth. she chanced to be wearing a warm blue wrapper which served as a gown. so now she only needed to slip her fur coat over it and pull down her gray squirrel cap over her brown curls. "be getting dressed, eugenia, while i find out what has happened. i'll come back in a moment," she advised. but once outside her stateroom, barbara discovered only a mild excitement. a few passengers were running up and down the narrow hallway, clinging to scanty costumes. one of them explained the situation to barbara. "nothing's much amiss, we are all getting too nervous these days," he commented. "our ship has just run up against a solid bank of fog. as we can't see an inch ahead of us, our captain has too good sense to go on in the darkness. we may have to stay here an hour, or twenty-four, there is no telling. hope a submarine won't come along and pick us off." and with this parting pleasantry barbara's new acquaintance departed. the next instant barbara returned and opened her stateroom door. "go back to sleep, gene dear, everything is serene," she said reassuringly; "there is only a heavy fog at sea. i want to go up on deck and investigate, so please don't worry about me." a few moments later barbara was groping her way about on deck until she discovered an empty steamer chair. this she crawled into, tucking her feet up under her and snuggling down close in the darkness. she could still hear the sailors rushing about on deck. now and then she could even catch the dim outline of a figure, but nothing else was discernible. the very lights suspended from the ship's side were pale and flickering. yet it was all immensely interesting. outside the ship both sky and water had apparently ceased to exist. one could see only a solid mass of gray-black fog like a wet and heavy veil overspreading the world. barbara had recovered from her fatigue with her few hours of sleep. never had she felt more wide awake or more excited. if only it were possible to see more. suddenly she jumped up from her chair. it is true the decks were wet and slippery and since she could not see her way about, nor be seen, she might be in danger of falling. nevertheless, barbara decided to risk the danger. a tumble more or less need not be serious and she was freezing from sitting still. and yet she had not the faintest intention or desire of going back to her stateroom. the fog might last for many hours, but then there was the chance that it might lift at any moment. barbara greatly desired to see the spectacle of a familiar world emerging from darkness into light. fortunately her side of the deck appeared to be entirely deserted. she rose and walked a few steps up and down, compelled to go slowly, for the fog lay like a damp weight upon her chest, pressing her backward with its dim, invisible hands. but after a little time, growing bolder when the desire to gaze down into the water swept over her, she turned and walked blindly forward. within a few paces she reached out to grasp the ship's rails. but instead her hands touched something warm and human. immediately she gave a smothered cry of embarrassment and fright. "i am so sorry," she murmured apologetically, then with a characteristic laugh. "but really i don't know whether i have run into you or you into me. will you please move to the right and i'll go to the left. then we need never meet again." "barbara," began a familiar voice. for the second time the girl's hands stretched forward, but this time they clung to the coat of the young fellow standing within a few feet of her. "dick thornton, can it be possible this is you, when you are in brussels?" she protested. "but then how can it be any one except you, although i have not seen you. if it is only your ghost i am holding on to, at least it is a very substantial one, and i never was so glad to meet any other ghost in my life." in answer dick thornton laughed out loud. "did anyone in the world ever talk in such a ridiculous fashion as barbara, and yet was there ever anyone so delightful?" he slipped his arm through the girl's. "let us walk up and down for a few moments while i explain the reality of my presence," he suggested, quietly taking his companion's consent for granted. "personally, i think it would be the more surprising if i were not here. did you think for an instant i would allow you and eugenia to go on this long trip alone, when eugenia has been so ill? i did not mention the subject to you girls, since i did not intend to have a discussion. but whether you allow it or not i shall be your faithful follower until you reach the little french farmhouse." barbara's eyes were swimming with unexpected tears. "you are the kindest person in the world always, dick," she answered. "and i can't tell you how glad i am to have you with us! i did dread the responsibility of gene more than i would confess. besides, i want you to see our 'house with the blue front door.' but i wonder if it is fair to mildred and nona to have you leave them for even a short time? your place is with them rather than any one else, isn't it?" "my place is beside you, barbara, whenever you are willing to have me," dick returned in such a matter-of-fact fashion that his companion did not at once understand the meaning of his words. "your place beside me?" she repeated slowly. "why, how is that possible when mildred is your sister and nona----" but dick was drawing her toward the side of the ship and now they were both leaning against the railing looking down at the glossy darkness beneath them. "yes, mildred is my sister and nona my friend," dick continued, "yet neither one of them can mean to me what the girl i would choose above all others to be my wife means. don't answer me for a moment, barbara. i have no delusion about your feeling for me, but that makes no difference. i want you to know that ever since those first days in new york you have filled the greater portion of my world. no matter what may happen to divide us, nor how far your life may lead away from mine, i shall not change." the girl and man were standing within only a few feet of each other. now barbara moved closer and laid her hand on her companion's coat sleeve. "i am not very anxious for anything to divide us, nor for my life to lead far away from yours," she whispered. at this moment the bank of fog rolled up as if it were a stage curtain being raised in answer to the prompter's bell, when for the first time that evening dick and barbara caught the vision of each other's faces. chapter xx _noel_ it was christmas morning in southern france. for several hours a light snow had been falling, but had not stayed upon the ground. yet it clothed the branches of the trees with white lace and filled the air with jewels. walking alone a slender girl with dark hair and eyes lifted her face to let the snow melt upon her cheeks. she looked fragile, as if she were just recovering from an illness, nor did her expression betray any special interest in christmas. "these woods are as lovely as i remember them," she said aloud. "it is true, i never could find a place in belgium i liked half so well." then she stopped a moment and glanced around her. "i do hope barbara and dick won't discover i have run away. i feel as much a truant as if i were a small girl. but they surely won't be tramping through my woods at present, when they assured me they would spend several hours at the chateau. so i can't be found out till it is too late. i feel i must see nicolete's little log house and nona's 'pool of melisande.'" ten minutes after eugenia arrived at the desired place. the lake of clear water which she had once described as the "pool of truth" was today covered with a thin coating of ice at its edges. the center was as untroubled as it had always been. above it tall evergreen trees leaned so close to one another that their summits almost touched. eugenia breathed deeply of the fragrance of the snow and the pine. the day was an unusually cold one for this part of the country, but the winter was being everywhere severe. it was as if nature would make no easier the task of her children's destruction of each other. but eugenia was not thinking of warlike things at this hour. she was merely feeling a physical pleasure in her own returning strength. yet just as she was congratulating herself on having been able to walk so far without tiring, the girl experienced a sudden, overpowering sensation of fatigue. for several moments she stood upright fighting her weakness; she even turned and started back toward home. then recognizing her own folly, eugenia looked for a place to rest. but she did not look very far nor in but one direction. yes, the log was there in the same place it had been six months before. with a half smile at herself eugenia sat down. she was not deceived, for she understood perfectly why she had wished to come back to this neighborhood and why today she had wanted to walk alone into these woods. but there could be no wrong in what she was doing, since no one would ever guess her reason. eugenia was sincerely pleased over barbara's and dick's happiness. but she would never confess herself so completely surprised as barbara demanded that she be. she merely announced that if one of the girls felt compelled to marry (and she supposed they could not all hope to escape the temptation of their nursing experiences in europe), at least she was grateful that barbara had chosen to bestow her affection upon an american. personally, she felt convinced that no foreign marriage could be a success. yet here sat eugenia in an extremely sentimental attitude with the light snow falling about her. more than this, she was in an equally sentimental state of mind. but then nothing of this kind matters when one chances to be entirely alone. dreams are one's own possession. then the girl heard a sound that entirely accorded with her train of thought. it was a slow velvet-like tread moving in her direction. in another moment duke had approached and laid his great head in her lap. he did not move again; there was no foolish wagging of his tail. these expressions of emotion were meant for lesser beasts; duke revealed his joy and his affection in a beautiful, almost a thrilling silence. eugenia had not seen her old friend since her arrival at the farmhouse a few days before. for some reason he had not called there with françois and she had not been outside the house until today. their trip had been a long and tiring one and she was more exhausted than she had expected to be. but this was a far more satisfactory reunion and eugenia was sincerely moved. she put her own thin cheek down on duke's silver head and remained as still as he was. truly _he_ had not forgotten! captain castaigne found them like this when he appeared within the next few seconds. he made no pretence of a greeting. instead he frowned upon his one-time friend as severely as she might have upon him had their positions been reversed. "it is not possible that you are in the woods in this snowstorm, eugenie! miss meade told me that i should find you at the little farmhouse. take my arm and we will return as quickly as possible." with entire meekness eugenia did as she was told. she did not even remember to be amused at this young frenchman's amazing fashion of ordering her about. but she was surprised into speechlessness at his unexpected appearance. "only yesterday your mother assured us you were in northern france with your regiment," eugenia murmured as she was being escorted along the path toward home. "she insisted that there was no possible prospect of your returning to this neighborhood in many months." captain castaigne smiled. "is that american frankness, eugenie? we french people prefer to leave certain things to the imagination. of course, i understand that you would never have come to the farmhouse had you dreamed of my being nearby. however, i am here for the purpose of seeing you. my mother did not intend to deceive you; i had not told her of my intention. but we will not talk of these things until we arrive at home. you are too weary to speak." this was so manifestly true that eugenia made no attempt at argument. she was fatigued, and yet there was something else keeping her silent. how splendidly well captain castaigne looked! his face was less boyish than she remembered it. but then she had not understood him at the beginning of their acquaintance. it had been stupid of her too, because no soldier receives the cross of the legion of honor who has not put aside boyish things. because it was christmas day, noel as the french term it, the living room at the farmhouse was gay with evergreens. but better than this, a real fire burned in the fireplace. eugenia let her companion take off her long nursing cloak and she herself removed her cap. then she stood revealed a different eugenia, because of barbara's taste and determination. instead of her uniform or her usual shabby, ill-made dress, she wore an exquisite pale gray crepe de chine, which made a beauty of her slenderness. about her throat there were folds of white and in her belt a dull, rose-velvet rose. this costume had been purchased in paris as the girls passed through and eugenia wore it today in honor of christmas. without a doubt eugenia looked pale and ill, but her hair was twisted about her head like a dull brown coronet and the shadows about her eyes revealed their new depth and sweetness. when she sat down again, drawing near the fire with a little shiver, captain castaigne came and knelt beside her. no american could have done this without awkwardness and self-consciousness. yet there was no hint of either in the young french officer's attitude. seeing him, eugenia forgot her past narrowness and the critical misunderstanding of a nature that cannot appreciate temperaments and circumstances unlike their own. she was reminded of the picture of a young french knight, the st. louis of france, whom she had seen among the frescoes of the pantheon in paris. very gravely captain castaigne raised eugenia's hand to his lips. "i care for you more than i did when i told you of my love and you would not believe. i shall go on caring. how long must i serve before you return my affection?" eugenia shook her head fretfully like a child. "but it isn't a question of my caring. i told you that there were a thousand other things that stood between us, henri." then she drew her hand away and laid it lightly upon the young man's head. "this house has many memories for me. perhaps when i am an old woman you will let me come back here and live a part of each year. may i buy the house from your mother? ask her as a favor to me?" eugenia was trying her best to return to her old half maternal treatment of the young officer. this had been the attitude which she had used in the months of his illness in the little "farmhouse with the blue front door." but this time their positions were reversed. "we will talk of that another time," he returned. "now you must be fair with me. i will not accept such an answer as you gave me before. i must be told the truth." captain castaigne had gotten up and stood looking down upon eugenia. "i return to my regiment tomorrow. you must tell me today." in reply the girl let her hands fall gently into her lap and gazed directly into the handsome, clear-cut face above her own. "why should i try to deceive you? it would be only sheer pretence. you are the only man i have ever cared for or ever shall. but i'll never marry you under any possible circumstances. i am too old and too unattractive and too--oh, a hundred other things." but captain castaigne was smiling in entire serenity. "we will marry at the little 'farmhouse with the blue front door' during my next leave of absence." but barbara and dick were at this moment entering the blue front door. half an hour later, when they had finished christmas dinner, dick thornton drew a magazine from his pocket, which had on its cover the sign of the red cross. "here is a poem some one in america has written called 'she of the red cross.' will you listen while i read it to you? to me the poem, of course, means barbara and to captain castaigne, eugenia." "she fulfills the dramatic destiny of woman, because she stands valiant, in the presence of pestilence, and faces woe unafraid, and binds up the wounds made by the wars of men. she fights to defeat pain, and to conquer torture, and to cheat death of his untimely prey. and her combat is for neither glory nor gain, but, with charity and mercy and compassion as her weapons, she storms incessantly the ramparts of grief. there thrills through her life never the sharp, sudden thunder of the charge, never the swift and ardent rush of the short, decisive conflict--the tumult of applauding nations does not reach her ears--and the courage that holds her heart high comes from the voice of her invincible soul. she fulfills the dramatic destiny of woman because, reared to await the homage of man and to receive his service, she becomes when the war trumps sound, the servitor of the world. and because whenever men have gone into battle, women have borne the real burden of the fray, and because since the beginning of time, man when he is hurt or maimed turns to her and finds, in her tenderness, the consolation and comfort which she alone can give. thus she of the red cross stands today, as woman has stood always, the most courageous and the most merciful figure in all history. she is the valor of the world." * * * * * * the fourth volume in the american red cross girls series will be called "the red cross girls with the russian army." in this volume the four girls will return to the scene of actual fighting. they will be with the russian army in their retreat. moreover, certain characters introduced in the first book will reappear in the fourth, so increasing the excitement and interest of the plot. a new romance differing from the others plays an unexpected part in the life of one of the girls. the story may safely promise to have more important developments than any of the past volumes. notes on nursing: what it is, and what it is not. by florence nightingale. new york: d. appleton and company fifth avenue . preface. the following notes are by no means intended as a rule of thought by which nurses can teach themselves to nurse, still less as a manual to teach nurses to nurse. they are meant simply to give hints for thought to women who have personal charge of the health of others. every woman, or at least almost every woman, in england has, at one time or another of her life, charge of the personal health of somebody, whether child or invalid,--in other words, every woman is a nurse. every day sanitary knowledge, or the knowledge of nursing, or in other words, of how to put the constitution in such a state as that it will have no disease, or that it can recover from disease, takes a higher place. it is recognized as the knowledge which every one ought to have--distinct from medical knowledge, which only a profession can have. if, then, every woman must at some time or other of her life, become a nurse, _i.e._, have charge of somebody's health, how immense and how valuable would be the produce of her united experience if every woman would think how to nurse. i do not pretend to teach her how, i ask her to teach herself, and for this purpose i venture to give her some hints. table of contents. ventilation and warming health of houses petty management noise variety taking food what food? bed and bedding light cleanliness of rooms and walls personal cleanliness chattering hopes and advices observation of the sick conclusion appendix notes on nursing: what it is, and what it is not. * * * * * [sidenote: disease a reparative process.] shall we begin by taking it as a general principle--that all disease, at some period or other of its course, is more or less a reparative process, not necessarily accompanied with suffering: an effort of nature to remedy a process of poisoning or of decay, which has taken place weeks, months, sometimes years beforehand, unnoticed, the termination of the disease being then, while the antecedent process was going on, determined? if we accept this as a general principle, we shall be immediately met with anecdotes and instances to prove the contrary. just so if we were to take, as a principle--all the climates of the earth are meant to be made habitable for man, by the efforts of man--the objection would be immediately raised,--will the top of mount blanc ever be made habitable? our answer would be, it will be many thousands of years before we have reached the bottom of mount blanc in making the earth healthy. wait till we have reached the bottom before we discuss the top. [sidenote: of the sufferings of disease, disease not always the cause.] in watching diseases, both in private houses and in public hospitals, the thing which strikes the experienced observer most forcibly is this, that the symptoms or the sufferings generally considered to be inevitable and incident to the disease are very often not symptoms of the disease at all, but of something quite different--of the want of fresh air, or of light, or of warmth, or of quiet, or of cleanliness, or of punctuality and care in the administration of diet, of each or of all of these. and this quite as much in private as in hospital nursing. the reparative process which nature has instituted and which we call disease, has been hindered by some want of knowledge or attention, in one or in all of these things, and pain, suffering, or interruption of the whole process sets in. if a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault not of the disease, but of the nursing. [sidenote: what nursing ought to do.] i use the word nursing for want of a better. it has been limited to signify little more than the administration of medicines and the application of poultices. it ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet--all at the least expense of vital power to the patient. [sidenote: nursing the sick little understood.] it has been said and written scores of times, that every woman makes a good nurse. i believe, on the contrary, that the very elements of nursing are all but unknown. by this i do not mean that the nurse is always to blame. bad sanitary, bad architectural, and bad administrative arrangements often make it impossible to nurse. but the art of nursing ought to include such arrangements as alone make what i understand by nursing, possible. the art of nursing, as now practised, seems to be expressly constituted to unmake what god had made disease to be, viz., a reparative process. [sidenote: nursing ought to assist the reparative process.] to recur to the first objection. if we are asked, is such or such a disease a reparative process? can such an illness be unaccompanied with suffering? will any care prevent such a patient from suffering this or that?--i humbly say, i do not know. but when you have done away with all that pain and suffering, which in patients are the symptoms not of their disease, but of the absence of one or all of the above-mentioned essentials to the success of nature's reparative processes, we shall then know what are the symptoms of and the sufferings inseparable from the disease. another and the commonest exclamation which will be instantly made is-- would you do nothing, then, in cholera, fever, &c.?--so deep-rooted and universal is the conviction that to give medicine is to be doing something, or rather everything; to give air, warmth, cleanliness, &c., is to do nothing. the reply is, that in these and many other similar diseases the exact value of particular remedies and modes of treatment is by no means ascertained, while there is universal experience as to the extreme importance of careful nursing in determining the issue of the disease. [sidenote: nursing the well.] ii. the very elements of what constitutes good nursing are as little understood for the well as for the sick. the same laws of health or of nursing, for they are in reality the same, obtain among the well as among the sick. the breaking of them produces only a less violent consequence among the former than among the latter,--and this sometimes, not always. it is constantly objected,--"but how can i obtain this medical knowledge? i am not a doctor. i must leave this to doctors." [sidenote: little understood.] oh, mothers of families! you who say this, do you know that one in every seven infants in this civilized land of england perishes before it is one year old? that, in london, two in every five die before they are five years old? and, in the other great cities of england, nearly one out of two?[ ] "the life duration of tender babies" (as some saturn, turned analytical chemist, says) "is the most delicate test" of sanitary conditions. is all this premature suffering and death necessary? or did nature intend mothers to be always accompanied by doctors? or is it better to learn the piano-forte than to learn the laws which subserve the preservation of offspring? macaulay somewhere says, that it is extraordinary that, whereas the laws of the motions of the heavenly bodies, far removed as they are from us, are perfectly well understood, the laws of the human mind, which are under our observation all day and every day, are no better understood than they were two thousand years ago. but how much more extraordinary is it that, whereas what we might call the coxcombries of education--_e.g._, the elements of astronomy--are now taught to every school-girl, neither mothers of families of any class, nor school-mistresses of any class, nor nurses of children, nor nurses of hospitals, are taught anything about those laws which god has assigned to the relations of our bodies with the world in which he has put them. in other words, the laws which make these bodies, into which he has put our minds, healthy or unhealthy organs of those minds, are all but unlearnt. not but that these laws--the laws of life--are in a certain measure understood, but not even mothers think it worth their while to study them--to study how to give their children healthy existences. they call it medical or physiological knowledge, fit only for doctors. another objection. we are constantly told,--"but the circumstances which govern our children's healths are beyond our control. what can we do with winds? there is the east wind. most people can tell before they get up in the morning whether the wind is in the east." to this one can answer with more certainty than to the former objections. who is it who knows when the wind is in the east? not the highland drover, certainly, exposed to the east wind, but the young lady who is worn out with the want of exposure to fresh air, to sunlight, &c. put the latter under as good sanitary circumstances as the former, and she too will not know when the wind is in the east. footnotes: [ ] [sidenote: curious deductions from an excessive death rate.] upon this fact the most wonderful deductions have been strung. for a long time an announcement something like the following has been going the round of the papers:--"more than , children die every year in london under years of age; therefore we want a children's hospital." this spring there was a prospectus issued, and divers other means taken to this effect:--"there is a great want of sanitary knowledge in women; therefore we want a women's hospital." now, both the above facts are too sadly true. but what is the deduction? the causes of the enormous child mortality are perfectly well known; they are chiefly want of cleanliness, want of ventilation, want of whitewashing; in one word, defective _household_ hygiene. the remedies are just as well known; and among them is certainly not the establishment of a child's hospital. this may be a want; just as there may be a want of hospital room for adults. but the registrar-general would certainly never think of giving us as a cause for the high rate of child mortality in (say) liverpool that there was not sufficient hospital room for children; nor would he urge upon us, as a remedy, to found an hospital for them. again, women, and the best women, are wofully deficient in sanitary knowledge; although it is to women that we must look, first and last, for its application, as far as _household_ hygiene is concerned. but who would ever think of citing the institution of a women's hospital as the way to cure this want? we have it, indeed, upon very high authority that there is some fear lest hospitals, as they have been _hitherto_, may not have generally increased, rather than diminished, the rate of mortality--especially of child mortality. i. ventilation and warming. [sidenote: first rule of nursing, to keep the air within as pure as the air without.] the very first canon of nursing, the first and the last thing upon which a nurse's attention must be fixed, the first essential to a patient, without which all the rest you can do for him is as nothing, with which i had almost said you may leave all the rest alone, is this: to keep the air he breathes as pure as the external air, without chilling him. yet what is so little attended, to? even where it is thought of at all, the most extraordinary misconceptions reign about it. even in admitting air into the patient's room or ward, few people ever think, where that air comes from. it may come from a corridor into which other wards are ventilated, from a hall, always unaired, always full of the fumes of gas, dinner, of various kinds of mustiness; from an underground kitchen, sink, washhouse, water-closet, or even, as i myself have had sorrowful experience, from open sewers loaded with filth; and with this the patient's room or ward is aired, as it is called--poisoned, it should rather be said. always, air from the air without, and that, too, through those windows, through which the air comes freshest. from a closed court, especially if the wind do not blow that way, air may come as stagnant as any from a hall or corridor. again, a thing i have often seen both in private houses and institutions. a room remains uninhabited; the fireplace is carefully fastened up with a board; the windows are never opened; probably the shutters are kept always shut; perhaps some kind of stores are kept in the room; no breath of fresh air can by possibility enter into that room, nor any ray of sun. the air is as stagnant, musty, and corrupt as it can by possibility be made. it is quite ripe to breed small-pox, scarlet-fever, diphtheria, or anything else you please.[ ] yet the nursery, ward, or sick room adjoining will positively be aired (?) by having the door opened into that room. or children will be put into that room, without previous preparation, to sleep. a short time ago a man walked into a back-kitchen in queen square, and cut the throat of a poor consumptive creature, sitting by the fire. the murderer did not deny the act, but simply said, "it's all right." of course he was mad. but in our case, the extraordinary thing is that the victim says, "it's all right," and that we are not mad. yet, although we "nose" the murderers, in the musty unaired unsunned room, the scarlet fever which is behind the door, or the fever and hospital gangrene which are stalking among the crowded beds of a hospital ward, we say, "it's all right." [sidenote: without chill.] with a proper supply of windows, and a proper supply of fuel in open fire places, fresh air is comparatively easy to secure when your patient or patients are in bed. never be afraid of open windows then. people don't catch cold in bed. this is a popular fallacy. with proper bed-clothes and hot bottles, if necessary, you can always keep a patient warm in bed, and well ventilate him at the same time. but a careless nurse, be her rank and education what it may, will stop up every cranny and keep a hot-house heat when her patient is in bed,-- and, if he is able to get up, leave him comparatively unprotected. the time when people take cold (and there are many ways of taking cold, besides a cold in the nose,) is when they first get up after the two-fold exhaustion of dressing and of having had the skin relaxed by many hours, perhaps days, in bed, and thereby rendered more incapable of re-action. then the same temperature which refreshes the patient in bed may destroy the patient just risen. and common sense will point out, that, while purity of air is essential, a temperature must be secured which shall not chill the patient. otherwise the best that can be expected will be a feverish re-action. to have the air within as pure as the air without, it is not necessary, as often appears to be thought, to make it as cold. in the afternoon again, without care, the patient whose vital powers have then risen often finds the room as close and oppressive as he found it cold in the morning. yet the nurse will be terrified, if a window is opened.[ ] [sidenote: open windows.] i know an intelligent humane house surgeon who makes a practice of keeping the ward windows open. the physicians and surgeons invariably close them while going their rounds; and the house surgeon very properly as invariably opens them whenever the doctors have turned their backs. in a little book on nursing, published a short time ago, we are told, that, "with proper care it is very seldom that the windows cannot be opened for a few minutes twice in the day to admit fresh air from without." i should think not; nor twice in the hour either. it only shows how little the subject has been considered. [sidenote: what kind of warmth desirable.] of all methods of keeping patients warm the very worst certainly is to depend for heat on the breath and bodies of the sick. i have known a medical officer keep his ward windows hermetically closed. thus exposing the sick to all the dangers of an infected atmosphere, because he was afraid that, by admitting fresh air, the temperature of the ward would be too much lowered. this is a destructive fallacy. to attempt to keep a ward warm at the expense of making the sick repeatedly breathe their own hot, humid, putrescing atmosphere is a certain way to delay recovery or to destroy life. [sidenote: bedrooms almost universally foul.] do you ever go into the bed-rooms of any persons of any class, whether they contain one, two, or twenty people, whether they hold sick or well, at night, or before the windows are opened in the morning, and ever find the air anything but unwholesomely close and foul? and why should it be so? and of how much importance it is that it should not be so? during sleep, the human body, even when in health, is far more injured by the influence of foul air than when awake. why can't you keep the air all night, then, as pure as the air without in the rooms you sleep in? but for this, you must have sufficient outlet for the impure air you make yourselves to go out; sufficient inlet for the pure air from without to come in. you must have open chimneys, open windows, or ventilators; no close curtains round your beds; no shutters or curtains to your windows, none of the contrivances by which you undermine your own health or destroy the chances of recovery of your sick.[ ] [sidenote: when warmth must be most carefully looked to.] a careful nurse will keep a constant watch over her sick, especially weak, protracted, and collapsed cases, to guard against the effects of the loss of vital heat by the patient himself. in certain diseased states much less heat is produced than in health; and there is a constant tendency to the decline and ultimate extinction of the vital powers by the call made upon them to sustain the heat of the body. cases where this occurs should be watched with the greatest care from hour to hour, i had almost said from minute to minute. the feet and legs should be examined by the hand from time to time, and whenever a tendency to chilling is discovered, hot bottles, hot bricks, or warm flannels, with some warm drink, should be made use of until the temperature is restored. the fire should be, if necessary, replenished. patients are frequently lost in the latter stages of disease from want of attention to such simple precautions. the nurse may be trusting to the patient's diet, or to his medicine, or to the occasional dose of stimulant which she is directed to give him, while the patient is all the while sinking from want of a little external warmth. such cases happen at all times, even during the height of summer. this fatal chill is most apt to occur towards early morning at the period of the lowest temperature of the twenty-four hours, and at the time when the effect of the preceding day's diets is exhausted. generally speaking, you may expect that weak patients will suffer cold much more in the morning than in the evening. the vital powers are much lower. if they are feverish at night, with burning hands and feet, they are almost sure to be chilly and shivering in the morning. but nurses are very fond of heating the foot-warmer at night, and of neglecting it in the morning, when they are busy. i should reverse the matter. all these things require common sense and care. yet perhaps in no one single thing is so little common sense shown, in all ranks, as in nursing.[ ] [sidenote: cold air not ventilation, nor fresh air a method of chill.] the extraordinary confusion between cold and ventilation, even in the minds of well educated people, illustrates this. to make a room cold is by no means necessarily to ventilate it. nor is it at all necessary, in order to ventilate a room, to chill it. yet, if a nurse finds a room close, she will let out the fire, thereby making it closer, or she will open the door into a cold room, without a fire, or an open window in it, by way of improving the ventilation. the safest atmosphere of all for a patient is a good fire and an open window, excepting in extremes of temperature. (yet no nurse can ever be made to understand this.) to ventilate a small room without draughts of course requires more care than to ventilate a large one. [sidenote: night air.] another extraordinary fallacy is the dread of night air. what air can we breathe at night but night air? the choice is between pure night air from without and foul night air from within. most people prefer the latter. an unaccountable choice. what will they say if it is proved to be true that fully one-half of all the disease we suffer from is occasioned by people sleeping with their windows shut? an open window most nights in the year can never hurt any one. this is not to say that light is not necessary for recovery. in great cities, night air is often the best and purest air to be had in the twenty-four hours. i could better understand in towns shutting the windows during the day than during the night, for the sake of the sick. the absence of smoke, the quiet, all tend to making night the best time for airing the patients. one of our highest medical authorities on consumption and climate has told me that the air in london is never so good as after ten o'clock at night. [sidenote: air from the outside. open your windows, shut your doors.] always air your room, then, from the outside air, if possible. windows are made to open; doors are made to shut--a truth which seems extremely difficult of apprehension. i have seen a careful nurse airing her patient's room through the door, near to which were two gaslights, (each of which consumes as much air as eleven men,) a kitchen, a corridor, the composition of the atmosphere in which consisted of gas, paint, foul air, never changed, full of effluvia, including a current of sewer air from an ill-placed sink, ascending in a continual stream by a well-staircase, and discharging themselves constantly into the patient's room. the window of the said room, if opened, was all that was desirable to air it. every room must be aired from without--every passage from without. but the fewer passages there are in a hospital the better. [sidenote: smoke.] if we are to preserve the air within as pure as the air without, it is needless to say that the chimney must not smoke. almost all smoky chimneys can be cured--from the bottom, not from the top. often it is only necessary to have an inlet for air to supply the fire, which is feeding itself, for want of this, from its own chimney. on the other hand, almost all chimneys can be made to smoke by a careless nurse, who lets the fire get low and then overwhelms it with coal; not, as we verily believe, in order to spare herself trouble, (for very rare is unkindness to the sick), but from not thinking what she is about. [sidenote: airing damp things in a patient's room.] in laying down the principle that this first object of the nurse must be to keep the air breathed by her patient as pure as the air without, it must not be forgotten that everything in the room which can give off effluvia, besides the patient, evaporates itself into his air. and it follows that there ought to be nothing in the room, excepting him, which can give off effluvia or moisture. out of all damp towels, &c., which become dry in the room, the damp, of course, goes into the patient's air. yet this "of course" seems as little thought of, as if it were an obsolete fiction. how very seldom you see a nurse who acknowledges by her practice that nothing at all ought to be aired in the patient's room, that nothing at all ought to be cooked at the patient's fire! indeed the arrangements often make this rule impossible to observe. if the nurse be a very careful one, she will, when the patient leaves his bed, but not his room, open the sheets wide, and throw the bed-clothes back, in order to air his bed. and she will spread the wet towels or flannels carefully out upon a horse, in order to dry them. now either these bed-clothes and towels are not dried and aired, or they dry and air themselves into the patient's air. and whether the damp and effluvia do him most harm in his air or in his bed, i leave to you to determine, for i cannot. [sidenote: effluvia from excreta.] even in health people cannot repeatedly breathe air in which they live with impunity, on account of its becoming charged with unwholesome matter from the lungs and skin. in disease where everything given off from the body is highly noxious and dangerous, not only must there be plenty of ventilation to carry off the effluvia, but everything which the patient passes must be instantly removed away, as being more noxious than even the emanations from the sick. of the fatal effects of the effluvia from the excreta it would seem unnecessary to speak, were they not so constantly neglected. concealing the utensils behind the vallance to the bed seems all the precaution which is thought necessary for safety in private nursing. did you but think for one moment of the atmosphere under that bed, the saturation of the under side of the mattress with the warm evaporations, you would be startled and frightened too! [sidenote: chamber utensils without lids.] the use of any chamber utensil _without a lid_[ ] should be utterly abolished, whether among sick or well. you can easily convince yourself of the necessity of this absolute rule, by taking one with a lid, and examining the under side of that lid. it will be found always covered, whenever the utensil is not empty, by condensed offensive moisture. where does that go, when there is no lid? earthenware, or if there is any wood, highly polished and varnished wood, are the only materials fit for patients' utensils. the very lid of the old abominable close-stool is enough to breed a pestilence. it becomes saturated with offensive matter, which scouring is only wanted to bring out. i prefer an earthenware lid as being always cleaner. but there are various good new-fashioned arrangements. [sidenote: abolish slop-pails.] a slop pail should never be brought into a sick room. it should be a rule invariable, rather more important in the private house than elsewhere, that the utensil should be carried directly to the water-closet, emptied there, rinsed there, and brought back. there should always be water and a cock in every water-closet for rinsing. but even if there is not, you must carry water there to rinse with. i have actually seen, in the private sick room, the utensils emptied into the foot-pan, and put back unrinsed under the bed. i can hardly say which is most abominable, whether to do this or to rinse the utensil _in_ the sick room. in the best hospitals it is now a rule that no slop-pail shall ever be brought into the wards, but that the utensils, shall be carried direct to be emptied and rinsed at the proper place. i would it were so in the private house. [sidenote: fumigations.] let no one ever depend upon fumigations, "disinfectants," and the like, for purifying the air. the offensive thing, not its smell, must be removed. a celebrated medical lecturer began one day, "fumigations, gentlemen, are of essential importance. they make such an abominable smell that they compel you to open the window." i wish all the disinfecting fluids invented made such an "abominable smell" that they forced you to admit fresh air. that would be a useful invention. footnotes: [ ] [sidenote: why are uninhabited rooms shut up?] the common idea as to uninhabited rooms is, that they may safely be left with doors, windows, shutters, and chimney-board, all closed-- hermetically sealed if possible--to keep out the dust, it is said; and that no harm will happen if the room is but opened a short hour before the inmates are put in. i have often been asked the question for uninhabited rooms.--but when ought the windows to be opened? the answer is--when ought they to be shut? [ ] it is very desirable that the windows in a sick room should be such that the patient shall, if he can move about, be able to open and shut them easily himself. in fact, the sick room is very seldom kept aired if this is not the case--so very few people have any perception of what is a healthy atmosphere for the sick. the sick man often says, "this room where i spend hours out of the , is fresher than the other where i only spend . because here i can manage the windows myself." and it is true. [ ] [sidenote: an air-test of essential consequence.] dr. angus smith's air test, if it could be made of simpler application, would be invaluable to use in every sleeping and sick room. just as without the use of a thermometer no nurse should ever put a patient into a bath, so should no nurse, or mother, or superintendent, be without the air test in any ward, nursery, or sleeping-room. if the main function of a nurse is to maintain the air within the room as fresh as the air without, without lowering the temperature, then she should always be provided with a thermometer which indicates the temperature, with an air test which indicates the organic matter of the air. but to be used, the latter must be made as simple a little instrument as the former, and both should be self-registering. the senses of nurses and mothers become so dulled to foul air, that they are perfectly unconscious of what an atmosphere they have let their children, patients, or charges, sleep in. but if the tell-tale air test were to exhibit in the morning, both to nurses and patients, and to the superior officer going round, what the atmosphere has been during the night, i question if any greater security could be afforded against a recurrence of the misdemeanor. and oh, the crowded national school! where so many children's epidemics have their origin, what a tale its air-test would tell! we should have parents saying, and saying rightly, "i will not send my child to that school, the air-test stands at 'horrid.'" and the dormitories of our great boarding schools! scarlet fever would be no more ascribed to contagion, but to its right cause, the air-test standing at "foul." we should hear no longer of "mysterious dispensations," and of "plague and pestilence," being "in god's hands," when, so far as we know, he has put them into our own. the little air-test would both betray the cause of these "mysterious pestilences," and call upon us to remedy it. [ ] with private sick, i think, but certainly with hospital sick, the nurse should never be satisfied as to the freshness of their atmosphere, unless she can feel the air gently moving over her face, when still. but it is often observed that the nurses who make the greatest outcry against open windows, are those who take the least pains to prevent dangerous draughts. the door of the patients' room or ward _must_ sometimes stand open to allow of persons passing in and out, or heavy things being carried in and out. the careful nurse will keep the door shut while she shuts the windows, and then, and not before, set the door open, so that a patient may not be left sitting up in bed, perhaps in a profuse perspiration, directly in the draught between the open door and window. neither, of course, should a patient, while being washed, or in any way exposed, remain in the draught of an open window or door. [ ] [sidenote: don't make your sick room into a sewer.] but never, never should the possession of this indispensable lid confirm you in the abominable practice of letting the chamber utensil remain in a patient's room unemptied, except once in the hours, i.e., when the bed is made. yes, impossible as it may appear, i have known the best and most attentive nurses guilty of this; aye, and have known, too, a patient afflicted with severe diarrhoea for ten days, and the nurse (a very good one) not know of it, because the chamber utensil (one with a lid) was emptied only once in hours, and that by the housemaid who came in and made the patient's bed every evening. as well might you have a sewer under the room, or think that in a water-closet the plug need be pulled up but once a day. also take care that your _lid_, as well as your utensil, be always thoroughly rinsed. if a nurse declines to do these kinds of things for her patient, "because it is not her business," i should say that nursing was not her calling. i have seen surgical "sisters," women whose hands were worth to them two or three guineas a-week, down upon their knees scouring a room or hut, because they thought it otherwise not fit for their patients to go into. i am far from wishing nurses to scour. it is a waste of power. but i do say that these women had the true nurse-calling--the good of their sick first, and second only the consideration what it was their "place" to do--and that women who wait for the housemaid to do this, or for the charwoman to do that, when their patients are suffering, have not the _making_ of a nurse in them. ii. health of houses.[ ] [sidenote: health of houses. five points essential.] there are five essential points in securing the health of houses:-- . pure air. . pure water. . efficient drainage. . cleanliness. . light. without these, no house can be healthy. and it will be unhealthy just in proportion as they are deficient. [sidenote: pure air.] . to have pure air, your house be so constructed as that the outer atmosphere shall find its way with ease to every corner of it. house architects hardly ever consider this. the object in building a house is to obtain the largest interest for the money, not to save doctors' bills to the tenants. but, if tenants should ever become so wise as to refuse to occupy unhealthy constructed houses, and if insurance companies should ever come to understand their interest so thoroughly as to pay a sanitary surveyor to look after the houses where their clients live, speculative architects would speedily be brought to their senses. as it is, they build what pays best. and there are always people foolish enough to take the houses they build. and if in the course of time the families die off, as is so often the case, nobody ever thinks of blaming any but providence[ ] for the result. ill-informed medical men aid in sustaining the delusion, by laying the blame on "current contagions." badly constructed houses do for the healthy what badly constructed hospitals do for the sick. once insure that the air in a house is stagnant, and sickness is certain to follow. [sidenote: pure water.] . pure water is more generally introduced into houses than it used to be, thanks to the exertions of the sanitary reformers. within the last few years, a large part of london was in the daily habit of using water polluted by the drainage of its sewers and water closets. this has happily been remedied. but, in many parts of the country, well water of a very impure kind is used for domestic purposes. and when epidemic disease shows itself, persons using such water are almost sure to suffer. [sidenote: drainage.] . it would be curious to ascertain by inspection, how many houses in london are really well drained. many people would say, surely all or most of them. but many people have no idea in what good drainage consists. they think that a sewer in the street, and a pipe leading to it from the house is good drainage. all the while the sewer may be nothing but a laboratory from which epidemic disease and ill health is being distilled into the house. no house with any untrapped drain pipe communicating immediately with a sewer, whether it be from water closet, sink, or gully-grate, can ever be healthy. an untrapped sink may at any time spread fever or pyaemia among the inmates of a palace. [sidenote: sinks.] the ordinary oblong sink is an abomination. that great surface of stone, which is always left wet, is always exhaling into the air. i have known whole houses and hospitals smell of the sink. i have met just as strong a stream of sewer air coming up the back staircase of a grand london house from the sink, as i have ever met at scutari; and i have seen the rooms in that house all ventilated by the open doors, and the passages all _un_ventilated by the closed windows, in order that as much of the sewer air as possible might be conducted into and retained in the bed-rooms. it is wonderful. another great evil in house construction is carrying drains underneath the house. such drains are never safe. all house drains should begin and end outside the walls. many people will readily admit, as a theory, the importance of these things. but how few are there who can intelligently trace disease in their households to such causes! is it not a fact, that when scarlet fever, measles, or small-pox appear among the children, the very first thought which occurs is, "where" the children can have "caught" the disease? and the parents immediately run over in their minds all the families with whom they may have been. they never think of looking at home for the source of the mischief. if a neighbour's child is seized with small-pox, the first question which occurs is whether it had been vaccinated. no one would undervalue vaccination; but it becomes of doubtful benefit to society when it leads people to look abroad for the source of evils which exist at home. [sidenote: cleanliness.] . without cleanliness, within and without your house, ventilation is comparatively useless. in certain foul districts of london, poor people used to object to open their windows and doors because of the foul smells that came in. rich people like to have their stables and dunghill near their houses. but does it ever occur to them that with many arrangements of this kind it would be safer to keep the windows shut than open? you cannot have the air of the house pure with dung-heaps under the windows. these are common all over london. and yet people are surprised that their children, brought up in large "well-aired" nurseries and bed-rooms suffer from children's epidemics. if they studied nature's laws in the matter of children's health, they would not be so surprised. there are other ways of having filth inside a house besides having dirt in heaps. old papered walls of years' standing, dirty carpets, uncleansed furniture, are just as ready sources of impurity to the air as if there were a dung-heap in the basement. people are so unaccustomed from education and habits to consider how to make a home healthy, that they either never think of it at all, and take every disease as a matter of course, to be "resigned to" when it comes "as from the hand of providence;" or if they ever entertain the idea of preserving the health of their household as a duty, they are very apt to commit all kinds of "negligences and ignorances" in performing it. [sidenote: light.] . a dark house is always an unhealthy house, always an ill-aired house, always a dirty house. want of light stops growth, and promotes scrofula, rickets, &c., among the children. people lose their health in a dark house, and if they get ill they cannot get well again in it. more will be said about this farther on. [sidenote: three common errors in managing the health of houses.] three out of many "negligences, and ignorances" in managing the health of houses generally, i will here mention as specimens-- . that the female head in charge of any building does not think it necessary to visit every hole and corner of it every day. how can she expect those who are under her to be more careful to maintain her house in a healthy condition than she who is in charge of it?-- . that it is not considered essential to air, to sun, and to clean rooms while uninhabited; which is simply ignoring the first elementary notion of sanitary things, and laying the ground ready for all kinds of diseases.-- . that the window, and one window, is considered enough to air a room. have you never observed that any room without a fire-place is always close? and, if you have a fire-place, would you cram it up not only with a chimney-board, but perhaps with a great wisp of brown paper, in the throat of the chimney--to prevent the soot from coming down, you say? if your chimney is foul, sweep it; but don't expect that you can ever air a room with only one aperture; don't suppose that to shut up a room is the way to keep it clean. it is the best way to foul the room and all that is in it. don't imagine that if you, who are in charge, don't look to all these things yourself, those under you will be more careful than you are. it appears as if the part of a mistress now is to complain of her servants, and to accept their excuses--not to show them how there need be neither complaints made nor excuses. [sidenote: head in charge must see to house hygiene, not do it herself.] but again, to look to all these things yourself does not mean to do them yourself. "i always open the windows," the head in charge often says. if you do it, it is by so much the better, certainly, than if it were not done at all. but can you not insure that it is done when not done by yourself? can you insure that it is not undone when your back is turned? this is what being "in charge" means. and a very important meaning it is, too. the former only implies that just what you can do with your own hands is done. the latter that what ought to be done is always done. [sidenote: does god think of these things so seriously?] and now, you think these things trifles, or at least exaggerated. but what you "think" or what i "think" matters little. let us see what god thinks of them. god always justifies his ways. while we are thinking, he has been teaching. i have known cases of hospital pyaemia quite as severe in handsome private houses as in any of the worst hospitals, and from the same cause, viz., foul air. yet nobody learnt the lesson. nobody learnt _anything_ at all from it. they went on _thinking_-- thinking that the sufferer had scratched his thumb, or that it was singular that "all the servants" had "whitlows," or that something was "much about this year; there is always sickness in our house." this is a favourite mode of thought--leading not to inquire what is the uniform cause of these general "whitlows," but to stifle all inquiry. in what sense is "sickness" being "always there," a justification of its being "there" at all? [sidenote: how does he carry out his laws?] [sidenote: how does he teach his laws?] i will tell you what was the cause of this hospital pyaemia being in that large private house. it was that the sewer air from an ill-placed sink was carefully conducted into all the rooms by sedulously opening all the doors, and closing all the passage windows. it was that the slops were emptied into the foot pans!--it was that the utensils were never properly rinsed;--it was that the chamber crockery was rinsed with dirty water;--it was that the beds were never properly shaken, aired, picked to pieces, or changed. it was that the carpets and curtains were always musty;--it was that the furniture was always dusty;--it was that the papered walls were saturated with dirt;--it was that the floors were never cleaned;--it was that the uninhabited rooms were never sunned, or cleaned, or aired;--it was that the cupboards were always reservoirs of foul air;--it was that the windows were always tight shut up at night;-- it was that no window was ever systematically opened even in the day, or that the right window was not opened. a person gasping for air might open a window for himself. but the servants were not taught to open the windows, to shut the doors; or they opened the windows upon a dank well between high walls, not upon the airier court; or they opened the room doors into the unaired halls and passages, by way of airing the rooms. now all this is not fancy, but fact. in that handsome house i have known in one summer three cases of hospital pyaemia, one of phlebitis, two of consumptive cough; all the _immediate_ products of foul air. when, in temperate climates, a house is more unhealthy in summer than in winter, it is a certain sign of something wrong. yet nobody learns the lesson. yes, god always justifies his ways. he is teaching while you are not learning. this poor body loses his finger, that one loses his life. and all from the most easily preventible causes.[ ] [sidenote: physical degeneration in families. its causes.] the houses of the grandmothers and great grandmothers of this generation, at least the country houses, with front door and back door always standing open, winter and summer, and a thorough draught always blowing through--with all the scrubbing, and cleaning, and polishing, and scouring which used to go on, the grandmothers, and still more the great grandmothers, always out of doors and never with a bonnet on except to go to church, these things entirely account for the fact so often seen of a great grandmother, who was a tower of physical vigour descending into a grandmother perhaps a little less vigorous but still sound as a bell and healthy to the core, into a mother languid and confined to her carriage and house, and lastly into a daughter sickly and confined to her bed. for, remember, even with a general decrease of mortality you may often find a race thus degenerating and still oftener a family. you may see poor little feeble washed-out rags, children of a noble stock, suffering morally and physically, throughout their useless, degenerate lives, and yet people who are going to marry and to bring more such into the world, will consult nothing but their own convenience as to where they are to live, or how they are to live. [sidenote: don't make your sickroom into a ventilating shaft for the whole house.] with regard to the health of houses where there is a sick person, it often happens that the sick room is made a ventilating shaft for the rest of the house. for while the house is kept as close, unaired, and dirty as usual, the window of the sick room is kept a little open always, and the door occasionally. now, there are certain sacrifices which a house with one sick person in it does make to that sick person: it ties up its knocker; it lays straw before it in the street. why can't it keep itself thoroughly clean and unusually well aired, in deference to the sick person? [sidenote: infection.] we must not forget what, in ordinary language, is called "infection;"[ ]--a thing of which people are generally so afraid that they frequently follow the very practice in regard to it which they ought to avoid. nothing used to be considered so infectious or contagious as small-pox; and people not very long ago used to cover up patients with heavy bed clothes, while they kept up large fires and shut the windows. small-pox, of course, under this _regime_, is very "infectious." people are somewhat wiser now in their management of this disease. they have ventured to cover the patients lightly and to keep the windows open; and we hear much less of the "infection" of small-pox than we used to do. but do people in our days act with more wisdom on the subject of "infection" in fevers--scarlet fever, measles, &c.--than their forefathers did with small-pox? does not the popular idea of "infection" involve that people should take greater care of themselves than of the patient? that, for instance, it is safer not to be too much with the patient, not to attend too much to his wants? perhaps the best illustration of the utter absurdity of this view of duty in attending on "infectious" diseases is afforded by what was very recently the practice, if it is not so even now, in some of the european lazarets--in which the plague-patient used to be condemned to the horrors of filth, overcrowding, and want of ventilation, while the medical attendant was ordered to examine the patient's tongue through an opera-glass and to toss him a lancet to open his abscesses with? true nursing ignores infection, except to prevent it. cleanliness and fresh air from open windows, with unremitting attention to the patient, are the only defence a true nurse either asks or needs. wise and humane management of the patient is the best safeguard against infection. [sidenote: why must children have measles, &c.,] there are not a few popular opinions, in regard to which it is useful at times to ask a question or two. for example, it is commonly thought that children must have what are commonly called "children's epidemics," "current contagions," &c., in other words, that they are born to have measles, hooping-cough, perhaps even scarlet fever, just as they are born to cut their teeth, if they live. now, do tell us, why must a child have measles? oh because, you say, we cannot keep it from infection--other children have measles--and it must take them--and it is safer that it should. but why must other children have measles? and if they have, why must yours have them too? if you believed in and observed the laws for preserving the health of houses which inculcate cleanliness, ventilation, white-washing, and other means, and which, by the way, _are laws_, as implicitly as you believe in the popular opinion, for it is nothing more than an opinion, that your child must have children's epidemics, don't you think that upon the whole your child would be more likely to escape altogether? footnotes: [ ] [sidenote: health of carriages.] the health of carriages, especially close carriages, is not of sufficient universal importance to mention here, otherwise than cursorily. children, who are always the most delicate test of sanitary conditions, generally cannot enter a close carriage without being sick-- and very lucky for them that it is so. a close carriage, with the horse-hair cushions and linings always saturated with organic matter, if to this be added the windows up, is one of the most unhealthy of human receptacles. the idea of taking an _airing_ in it is something preposterous. dr. angus smith has shown that a crowded railway carriage, which goes at the rate of miles an hour, is as unwholesome as the strong smell of a sewer, or as a back yard in one of the most unhealthy courts off one of the most unhealthy streets in manchester. [ ] god lays down certain physical laws. upon his carrying out such laws depends our responsibility (that much abused word), for how could we have any responsibility for actions, the results of which we could not foresee--which would be the case if the carrying out of his laws were not certain. yet we seem to be continually expecting that he will work a miracle--i.e., break his own laws expressly to relieve us of responsibility. [ ] [sidenote: servants rooms.] i must say a word about servants' bed-rooms. from the way they are built, but oftener from the way they are kept, and from no intelligent inspection whatever being exercised over them, they are almost invariably dens of foul air, and the "servants' health" suffers in an "unaccountable" (?) way, even in the country. for i am by no means speaking only of london houses, where too often servants are put to live under the ground and over the roof. but in a country "_mansion_," which was really a "mansion," (not after the fashion of advertisements,) i have known three maids who slept in the same room ill of scarlet fever. "how catching it is," was of course the remark. one look at the room, one smell of the room, was quite enough. it was no longer "unaccountable." the room was not a small one; it was up stairs, and it had two large windows--but nearly every one of the neglects enumerated above was there. [ ] [sidenote: diseases are not individuals arranged in classes, like cats and dogs, but conditions growing out of one another.] is it not living in a continual mistake to look upon diseases, as we do now, as separate entities, which _must_ exist, like cats and dogs? instead of looking upon them as conditions, like a dirty and a clean condition, and just as much under our own control; or rather as the reactions of kindly nature, against the conditions in which we have placed ourselves. i was brought up, both by scientific men and ignorant women, distinctly to believe that small-pox, for instance, was a thing of which there was once a first specimen in the world, which went on propagating itself, in a perpetual chain of descent, just as much as that there was a first dog, (or a first pair of dogs,) and that small-pox would not begin itself any more than a new dog would begin without there having been a parent dog. since then i have seen with my eyes and smelt with my nose small-pox growing up in first specimens, either in close rooms, or in overcrowded wards, where it could not by any possibility have been "caught," but must have begun. nay, more, i have seen diseases begin, grow up, and pass into one another. now, dogs do not pass into cats. i have seen, for instance, with a little overcrowding, continued fever grow up; and with a little more, typhoid fever; and with a little more, typhus, and all in the same ward or hut. would it not be far better, truer, and more practical, if we looked upon disease in this light? for diseases, as all experiences hows,[transcriber's note: possibly typo for "show"] are adjectives, not noun substantives. iii. petty management. [sidenote: petty management.] all the results of good nursing, as detailed in these notes, may be spoiled or utterly negatived by one defect, viz.: in petty management, or in other words, by not knowing how to manage that what you do when you are there, shall be done when you are not there. the most devoted friend or nurse cannot be always _there_. nor is it desirable that she should. and she may give up her health, all her other duties, and yet, for want of a little management, be not one-half so efficient as another who is not one-half so devoted, but who has this art of multiplying herself--that is to say, the patient of the first will not really be so well cared for, as the patient of the second. it is as impossible in a book to teach a person in charge of sick how to _manage_, as it is to teach her how to nurse. circumstances must vary with each different case. but it _is_ possible to press upon her to think for herself: now what does happen during my absence? i am obliged to be away on tuesday. but fresh air, or punctuality is not less important to my patient on tuesday than it was on monday. or: at p.m. i am never with my patient; but quiet is of no less consequence to him at than it was at minutes to . curious as it may seem, this very obvious consideration occurs comparatively to few, or, if it does occur, it is only to cause the devoted friend or nurse to be absent fewer hours or fewer minutes from her patient--not to arrange so as that no minute and no hour shall be for her patient without the essentials of her nursing. [sidenote: illustrations of the want of it.] a very few instances will be sufficient, not as precepts, but as illustrations. [sidenote: strangers coming into the sick room.] a strange washerwoman, coming late at night for the "things," will burst in by mistake to the patient's sickroom, after he has fallen into his first doze, giving him a shock, the effects of which are irremediable, though he himself laughs at the cause, and probably never even mentions it. the nurse who is, and is quite right to be, at her supper, has not provided that the washerwoman shall not lose her way and go into the wrong room. [sidenote: sick room airing the whole house.] the patient's room may always have the window open. but the passage outside the patient's room, though provided with several large windows, may never have one open. because it is not understood that the charge of the sick-room extends to the charge of the passage. and thus, as often happens, the nurse makes it her business to turn the patient's room into a ventilating shaft for the foul air of the whole house. [sidenote: uninhabited room fouling the whole house.] an uninhabited room, a newly-painted room,[ ] an uncleaned closet or cupboard, may often become the reservoir of foul air for the whole house, because the person in charge never thinks of arranging that these places shall be always aired, always cleaned; she merely opens the window herself "when she goes in." [sidenote: delivery and non-delivery of letters and messages.] an agitating letter or message may be delivered, or an important letter or message _not_ delivered; a visitor whom it was of consequence to see, may be refused, or whom it was of still more consequence to _not_ see may be admitted--because the person in charge has never asked herself this question, what is done when i am not there?[ ] at all events, one may safely say, a nurse cannot be with the patient, open the door, eat her meals, take a message, all at one and the same time. nevertheless the person in charge never seems to look the impossibility in the face. add to this that the _attempting_ this impossibility does more to increase the poor patient's hurry and nervousness than anything else. [sidenote: partial measures such as "being always in the way" yourself, increase instead of saving the patient's anxiety. because they must be only partial.] it is never thought that the patient remembers these things if you do not. he has not only to think whether the visit or letter may arrive, but whether you will be in the way at the particular day and hour when it may arrive. so that your _partial_ measures for "being in the way" yourself, only increase the necessity for his thought. whereas, if you could but arrange that the thing should always be done whether you are there or not, he need never think at all about it. for the above reasons, whatever a patient _can_ do for himself, it is better, i.e. less anxiety, for him to do for himself, unless the person in charge has the spirit of management. it is evidently much less exertion for a patient to answer a letter for himself by return of post, than to have four conversations, wait five days, have six anxieties before it is off his mind, before the person who has to answer it has done so. apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion. remember, he is face to face with his enemy all the time, internally wrestling with him, having long imaginary conversations with him. you are thinking of something else. "rid him of his adversary quickly," is a first rule with the sick.[ ] for the same reasons, always tell a patient and tell him beforehand when you are going out and when you will be back, whether it is for a day, an hour, or ten minutes. you fancy perhaps that it is better for him if he does not find out your going at all, better for him if you do not make yourself "of too much importance" to him; or else you cannot bear to give him the pain or the anxiety of the temporary separation. no such thing. you _ought_ to go, we will suppose. health or duty requires it. then say so to the patient openly. if you go without his knowing it, and he finds it out, he never will feel secure again that the things which depend upon you will be done when you are away, and in nine cases out of ten he will be right. if you go out without telling him when you will be back, he can take no measures nor precautions as to the things which concern you both, or which you do for him. [sidenote: what is the cause of half the accidents which happen?] if you look into the reports of trials or accidents, and especially of suicides, or into the medical history of fatal cases, it is almost incredible how often the whole thing turns upon something which has happened because "he," or still oftener "she," "was not there." but it is still more incredible how often, how almost always this is accepted as a sufficient reason, a justification; why, the very fact of the thing having happened is the proof of its not being a justification. the person in charge was quite right not to be "_there_," he was called away for quite sufficient reason, or he was away for a daily recurring and unavoidable cause; yet no provision was made to supply his absence. the fault was not in his "being away," but in there being no management to supplement his "being away." when the sun is under a total eclipse or during his nightly absence, we light candles. but it would seem as if it did not occur to us that we must also supplement the person in charge of sick or of children, whether under an occasional eclipse or during a regular absence. in institutions where many lives would be lost and the effect of such want of management would be terrible and patent, there is less of it than in the private house.[ ] but in both, let whoever is in charge keep this simple question in her head (_not,_ how can i always do this right thing myself, but) how can i provide for this right thing to be always done? then, when anything wrong has actually happened in consequence of her absence, which absence we will suppose to have been quite right, let her question still be (_not,_ how can i provide against any more of such absences? which is neither possible nor desirable, but) how can i provide against anything wrong arising out of my absence? [sidenote: what it is to be "in charge."] how few men, or even women, understand, either in great or in little things, what it is the being "in charge"--i mean, know how to carry out a "charge." from the most colossal calamities, down to the most trifling accidents, results are often traced (or rather _not_ traced) to such want of some one "in charge" or of his knowing how to be "in charge." a short time ago the bursting of a funnel-casing on board the finest and strongest ship that ever was built, on her trial trip, destroyed several lives and put several hundreds in jeopardy--not from any undetected flaw in her new and untried works--but from a tap being closed which ought not to have been closed--from what every child knows would make its mother's tea-kettle burst. and this simply because no one seemed to know what it is to be "in charge," or _who_ was in charge. nay more, the jury at the inquest actually altogether ignored the same, and apparently considered the tap "in charge," for they gave as a verdict "accidental death." this is the meaning of the word, on a large scale. on a much smaller scale, it happened, a short time ago, that an insane person burned herself slowly and intentionally to death, while in her doctor's charge and almost in her nurse's presence. yet neither was considered "at all to blame." the very fact of the accident happening proves its own case. there is nothing more to be said. either they did not know their business or they did not know how to perform it. to be "in charge" is certainly not only to carry out the proper measures yourself but to see that every one else does so too; to see that no one either wilfully or ignorantly thwarts or prevents such measures. it is neither to do everything yourself nor to appoint a number of people to each duty, but to ensure that each does that duty to which he is appointed. this is the meaning which must be attached to the word by (above all) those "in charge" of sick, whether of numbers or of individuals, (and indeed i think it is with individual sick that it is least understood. one sick person is often waited on by four with less precision, and is really less cared for than ten who are waited on by one; or at least than who are waited on by ; and all for want of this one person "in charge.") it is often said that there are few good servants now; i say there are few good mistresses now. as the jury seems to have thought the tap was in charge of the ship's safety, so mistresses now seem to think the house is in charge of itself. they neither know how to give orders, nor how to teach their servants to obey orders--_i.e._, to obey intelligently, which is the real meaning of all discipline. again, people who are in charge often seem to have a pride in feeling that they will be "missed," that no one can understand or carry on their arrangements, their system, books, accounts, &c., but themselves. it seems to me that the pride is rather in carrying on a system, in keeping stores, closets, books, accounts, &c., so that any body can understand and carry them on--so that, in case of absence or illness, one can deliver every thing up to others and know that all will go on as usual, and that one shall never be missed. [sidenote: why hired nurses give so much trouble.] note.--it is often complained, that professional nurses, brought into private families, in case of sickness, make themselves intolerable by "ordering about" the other servants, under plea of not neglecting the patient. both things are true; the patient is often neglected, and the servants are often unfairly "put upon." but the fault is generally in the want of management of the head in charge. it is surely for her to arrange both that the nurse's place is, when necessary, supplemented, and that the patient is never neglected--things with a little management quite compatible, and indeed only attainable together. it is certainly not for the nurse to "order about" the servants. footnotes: [ ] [sidenote: lingering smell of paint a want of care.] that excellent paper, the _builder_, mentions the lingering of the smell of paint for a month about a house as a proof of want of ventilation. certainly--and, where there are ample windows to open, and these are never opened to get rid of the smell of paint, it is a proof of want of management in using the means of ventilation. of course the smell will then remain for months. why should it go? [ ] [sidenote: why let your patient ever be surprised?] why should you let your patient ever be surprised, except by thieves? i do not know. in england, people do not come down the chimney, or through the window, unless they are thieves. they come in by the door, and somebody must open the door to them. the "somebody" charged with opening the door is one of two, three, or at most four persons. why cannot these, at most, four persons be put in charge as to what is to be done when there is a ring at the door-bell? the sentry at a post is changed much oftener than any servant at a private house or institution can possibly be. but what should we think of such an excuse as this: that the enemy had entered such a post because a and not b had been on guard? yet i have constantly heard such an excuse made in the private house or institution, and accepted: viz., that such a person had been "let in" or _not_ "let in," and such a parcel had been wrongly delivered or lost because a and not b had opened the door! [ ] there are many physical operations where _coeteris paribus_ the danger is in a direct ratio to the time the operation lasts; and _coeteris paribus_ the operator's success will be in direct ratio to his quickness. now there are many mental operations where exactly the same rule holds good with the sick; _coeteris paribus_ their capability of bearing such operations depends directly on the quickness, _without hurry_, with which they can be got through. [ ] [sidenote: petty management better understood in institutions than in private houses.] so true is this that i could mention two cases of women of very high position, both of whom died in the same way of the consequences of a surgical operation. and in both cases, i was told by the highest authority that the fatal result would not have happened in a london hospital. [sidenote: what institutions are the exception?] but, as far as regards the art of petty management in hospitals, all the military hospitals i know must be excluded. upon my own experience i stand, and i solemnly declare that i have seen or known of fatal accidents, such as suicides in _delirium tremens,_ bleedings to death, dying patients dragged out of bed by drunken medical staff corps men, and many other things less patent and striking, which would not have happened in london civil hospitals nursed by women. the medical officers should be absolved from all blame in these accidents. how can a medical officer mount guard all day and all night over a patient (say) in _delirium tremens?_ the fault lies in there being no organized system of attendance. were a trustworthy _man_ in charge of each ward, or set of wards, not as office clerk, but as head nurse, (and head nurse the best hospital serjeant, or ward master, is not now and cannot be, from default of the proper regulations,) the thing would not, in all probability, have happened. but were a trustworthy _woman_ in charge of the ward, or set of wards, the thing would not, in all certainty, have happened. in other words, it does not happen where a trustworthy woman is really in charge. and, in these remarks, i by no means refer only to exceptional times of great emergency in war hospitals, but also, and quite as much, to the ordinary run of military hospitals at home, in time of peace; or to a time in war when our army was actually more healthy than at home in peace, and the pressure on our hospitals consequently much less. [sidenote: nursing in regimental hospitals.] it is often said that, in regimental hospitals, patients ought to "nurse each other," because the number of sick altogether being, say, but thirty, and out of these one only perhaps being seriously ill, and the other twenty-nine having little the matter with them, and nothing to do, they should be set to nurse the one; also, that soldiers are so trained to obey, that they will be the most obedient, and therefore the best of nurses, add to which they are always kind to their comrades. now, have those who say this, considered that, in order to obey, you must know _how_ to obey, and that these soldiers certainly do not know how to obey in nursing. i have seen these "kind" fellows (and how kind they are no one knows so well as myself) move a comrade so that, in one case at least, the man died in the act. i have seen the comrades' "kindness" produce abundance of spirits, to be drunk in secret. let no one understand by this that female nurses ought to, or could be introduced in regimental hospitals. it would be most undesirable, even were it not impossible. but the head nurseship of a hospital serjeant is the more essential, the more important, the more inexperienced the nurses. undoubtedly, a london hospital "sister" does sometimes set relays of patients to watch a critical case; but, undoubtedly also, always under her own superintendence; and she is called to whenever there is something to be done, and she knows how to do it. the patients are not left to do it of their own unassisted genius, however "kind" and willing they may be. iv. noise. [sidenote: unnecessary noise.] unnecessary noise, or noise that creates an expectation in the mind, is that which hurts a patient. it is rarely the loudness of the noise, the effect upon the organ of the ear itself, which appears to affect the sick. how well a patient will generally bear, _e. g._, the putting up of a scaffolding close to the house, when he cannot bear the talking, still less the whispering, especially if it be of a familiar voice, outside his door. there are certain patients, no doubt, especially where there is slight concussion or other disturbance of the brain, who are affected by mere noise. but intermittent noise, or sudden and sharp noise, in these as in all other cases, affects far more than continuous noise--noise with jar far more than noise without. of one thing you may be certain, that anything which wakes a patient suddenly out of his sleep will invariably put him into a state of greater excitement, do him more serious, aye, and lasting mischief, than any continuous noise, however loud. [sidenote: never let a patient be waked out of his first sleep.] never to allow a patient to be waked, intentionally or accidentally, is a _sine qua non_ of all good nursing. if he is roused out of his first sleep, he is almost certain to have no more sleep. it is a curious but quite intelligible fact that, if a patient is waked after a few hours' instead of a few minutes' sleep, he is much more likely to sleep again. because pain, like irritability of brain, perpetuates and intensifies itself. if you have gained a respite of either in sleep you have gained more than the mere respite. both the probability of recurrence and of the same intensity will be diminished; whereas both will be terribly increased by want of sleep. this is the reason why sleep is so all-important. this is the reason why a patient waked in the early part of his sleep loses not only his sleep, but his power to sleep. a healthy person who allows himself to sleep during the day will lose his sleep at night. but it is exactly the reverse with the sick generally; the more they sleep, the better will they be able to sleep. [sidenote: noise which excites expectation.] [sidenote: whispered conversation in the room.] i have often been surprised at the thoughtlessness, (resulting in cruelty, quite unintentionally) of friends or of doctors who will hold a long conversation just in the room or passage adjoining to the room of the patient, who is either every moment expecting them to come in, or who has just seen them, and knows they are talking about him. if he is an amiable patient, he will try to occupy his attention elsewhere and not to listen--and this makes matters worse--for the strain upon his attention and the effort he makes are so great that it is well if he is not worse for hours after. if it is a whispered conversation in the same room, then it is absolutely cruel; for it is impossible that the patient's attention should not be involuntarily strained to hear. walking on tip-toe, doing any thing in the room very slowly, are injurious, for exactly the same reasons. a firm light quick step, a steady quick hand are the desiderata; not the slow, lingering, shuffling foot, the timid, uncertain touch. slowness is not gentleness, though it is often mistaken for such: quickness, lightness, and gentleness are quite compatible. again, if friends and doctors did but watch, as nurses can and should watch, the features sharpening, the eyes growing almost wild, of fever patients who are listening for the entrance from the corridor of the persons whose voices they are hearing there, these would never run the risk again of creating such expectation, or irritation of mind.--such unnecessary noise has undoubtedly induced or aggravated delirium in many cases. i have known such--in one case death ensued. it is but fair to say that this death was attributed to fright. it was the result of a long whispered conversation, within sight of the patient, about an impending operation; but any one who has known the more than stoicism, the cheerful coolness, with which the certainty of an operation will be accepted by any patient, capable of bearing an operation at all, if it is properly communicated to him, will hesitate to believe that it was mere fear which produced, as was averred, the fatal result in this instance. it was rather the uncertainty, the strained expectation as to what was to be decided upon. [sidenote: or just outside the door.] i need hardly say that the other common cause, namely, for a doctor or friend to leave the patient and communicate his opinion on the result of his visit to the friends just outside the patient's door, or in the adjoining room, after the visit, but within hearing or knowledge of the patient is, if possible, worst of all. [sidenote: noise of female dress.] it is, i think, alarming, peculiarly at this time, when the female ink-bottles are perpetually impressing upon us "woman's" "particular worth and general missionariness," to see that the dress of women is daily more and more unfitting them for any "mission," or usefulness at all. it is equally unfitted for all poetic and all domestic purposes. a man is now a more handy and far less objectionable being in a sick room than a woman. compelled by her dress, every woman now either shuffles or waddles--only a man can cross the floor of a sick-room without shaking it! what is become of woman's light step?--the firm, light, quick step we have been asking for? unnecessary noise, then, is the most cruel absence of care which can be inflicted either on sick or well. for, in all these remarks, the sick are only mentioned as suffering in a greater proportion than the well from precisely the same causes. unnecessary (although slight) noise injures a sick person much more than necessary noise (of a much greater amount). [sidenote: patient's repulsion to nurses who rustle.] all doctrines about mysterious affinities and aversions will be found to resolve themselves very much, if not entirely, into presence or absence of care in these things. a nurse who rustles (i am speaking of nurses professional and unprofessional) is the horror of a patient, though perhaps he does not know why. the fidget of silk and of crinoline, the rattling of keys, the creaking of stays and of shoes, will do a patient more harm than all the medicines in the world will do him good. the noiseless step of woman, the noiseless drapery of woman, are mere figures of speech in this day. her skirts (and well if they do not throw down some piece of furniture) will at least brush against every article in the room as she moves.[ ] again, one nurse cannot open the door without making everything rattle. or she opens the door unnecessarily often, for want of remembering all the articles that might be brought in at once. a good nurse will always make sure that no door or window in her patient's room shall rattle or creak; that no blind or curtain shall, by any change of wind through the open window be made to flap--especially will she be careful of all this before she leaves her patients for the night. if you wait till your patients tell you, or remind you of these things, where is the use of their having a nurse? there are more shy than exacting patients, in all classes; and many a patient passes a bad night, time after time, rather than remind his nurse every night of all the things she has forgotten. if there are blinds to your windows, always take care to have them well up, when they are not being used. a little piece slipping down, and flapping with every draught, will distract a patient. [sidenote: hurry peculiarly hurtful to sick.] all hurry or bustle is peculiarly painful to the sick. and when a patient has compulsory occupations to engage him, instead of having simply to amuse himself, it becomes doubly injurious. the friend who remains standing and fidgetting about while a patient is talking business to him, or the friend who sits and proses, the one from an idea of not letting the patient talk, the other from an idea of amusing him, --each is equally inconsiderate. always sit down when a sick person is talking business to you, show no signs of hurry give complete attention and full consideration if your advice is wanted, and go away the moment the subject is ended. [sidenote: how to visit the sick and not hurt them.] always sit within the patient's view, so that when you speak to him he has not painfully to turn his head round in order to look at you. everybody involuntarily looks at the person speaking. if you make this act a wearisome one on the part of the patient you are doing him harm. so also if by continuing to stand you make him continuously raise his eyes to see you. be as motionless as possible, and never gesticulate in speaking to the sick. never make a patient repeat a message or request, especially if it be some time after. occupied patients are often accused of doing too much of their own business. they are instinctively right. how often you hear the person, charged with the request of giving the message or writing the letter, say half an hour afterwards to the patient, "did you appoint o'clock?" or, "what did you say was the address?" or ask perhaps some much more agitating question--thus causing the patient the effort of memory, or worse still, of decision, all over again. it is really less exertion to him to write his letters himself. this is the almost universal experience of occupied invalids. this brings us to another caution. never speak to an invalid from behind, nor from the door, nor from any distance from him, nor when he is doing anything. the official politeness of servants in these things is so grateful to invalids, that many prefer, without knowing why, having none but servants about them. [sidenote: these things not fancy.] these things are not fancy. if we consider that, with sick as with well, every thought decomposes some nervous matter,--that decomposition as well as re-composition of nervous matter is always going on, and more quickly with the sick than with the well,--that, to obtrude abruptly another thought upon the brain while it is in the act of destroying nervous matter by thinking, is calling upon it to make a new exertion,-- if we consider these things, which are facts, not fancies, we shall remember that we are doing positive injury by interrupting, by "startling a fanciful" person, as it is called. alas! it is no fancy. [sidenote: interruption damaging to sick.] if the invalid is forced, by his avocations, to continue occupations requiring much thinking, the injury is doubly great. in feeding a patient suffering under delirium or stupor you may suffocate him, by giving him his food suddenly, but if you rub his lips gently with a spoon and thus attract his attention, he will swallow the food unconsciously, but with perfect safety. thus it is with the brain. if you offer it a thought, especially one requiring a decision, abruptly, you do it a real not fanciful injury. never speak to a sick person suddenly; but, at the same time, do not keep his expectation on the tiptoe. [sidenote: and to well.] this rule, indeed, applies to the well quite as much as to the sick. i have never known persons who exposed themselves for years to constant interruption who did not muddle away their intellects by it at last. the process with them may be accomplished without pain. with the sick, pain gives warning of the injury. [sidenote: keeping a patient standing.] do not meet or overtake a patient who is moving about in order to speak to him, or to give him any message or letter. you might just as well give him a box on the ear. i have seen a patient fall flat on the ground who was standing when his nurse came into the room. this was an accident which might have happened to the most careful nurse. but the other is done with intention. a patient in such a state is not going to the east indies. if you would wait ten seconds, or walk ten yards further, any promenade he could make would be over. you do not know the effort it is to a patient to remain standing for even a quarter of a minute to listen to you. if i had not seen the thing done by the kindest nurses and friends, i should have thought this caution quite superfluous.[ ] [sidenote: patients dread surprise.] patients are often accused of being able to "do much more when nobody is by." it is quite true that they can. unless nurses can be brought to attend to considerations of the kind of which we have given here but a few specimens, a very weak patient finds it really much less exertion to do things for himself than to ask for them. and he will, in order to do them, (very innocently and from instinct) calculate the time his nurse is likely to be absent, from a fear of her "coming in upon" him or speaking to him, just at the moment when he finds it quite as much as he can do to crawl from his bed to his chair, or from one room to another, or down stairs, or out of doors for a few minutes. some extra call made upon his attention at that moment will quite upset him. in these cases you may be sure that a patient in the state we have described does not make such exertions more than once or twice a day, and probably much about the same hour every day. and it is hard, indeed, if nurse and friends cannot calculate so as to let him make them undisturbed. remember, that many patients can walk who cannot stand or even sit up. standing is, of all positions, the most trying to a weak patient. everything you do in a patient's room, after he is "put up" for the night, increases tenfold the risk of his having a bad night. but, if you rouse him up after he has fallen asleep, you do not risk, you secure him a bad night. one hint i would give to all who attend or visit the sick, to all who have to pronounce an opinion upon sickness or its progress. come back and look at your patient _after_ he has had an hour's animated conversation with you. it is the best test of his real state we know. but never pronounce upon him from merely seeing what he does, or how he looks, during such a conversation. learn also carefully and exactly, if you can, how he passed the night after it. [sidenote: effects of over-exertion on sick.] people rarely, if ever, faint while making an exertion. it is after it is over. indeed, almost every effect of over-exertion appears after, not during such exertion. it is the highest folly to judge of the sick, as is so often done, when you see them merely during a period of excitement. people have very often died of that which, it has been proclaimed at the time, has "done them no harm."[ ] remember never to lean against, sit upon, or unnecessarily shake, or even touch the bed in which a patient lies. this is invariably a painful annoyance. if you shake the chair on which he sits, he has a point by which to steady himself, in his feet. but on a bed or sofa, he is entirely at your mercy, and he feels every jar you give him all through him. [sidenote: difference between real and fancy patients.] in all that we have said, both here and elsewhere, let it be distinctly understood that we are not speaking of hypochondriacs. to distinguish between real and fancied disease forms an important branch of the education of a nurse. to manage fancy patients forms an important branch of her duties. but the nursing which real and that which fancied patients require is of different, or rather of opposite, character. and the latter will not be spoken of here. indeed, many of the symptoms which are here mentioned are those which distinguish real from fancied disease. it is true that hypochondriacs very often do that behind a nurse's back which they would not do before her face. many such i have had as patients who scarcely ate anything at their regular meals; but if you concealed food for them in a drawer, they would take it at night or in secret. but this is from quite a different motive. they do it from the wish to conceal. whereas the real patient will often boast to his nurse or doctor, if these do not shake their heads at him, of how much he has done, or eaten or walked. to return to real disease. [sidenote: conciseness necessary with sick.] conciseness and decision are, above all things, necessary with the sick. let your thought expressed to them be concisely and decidedly expressed. what doubt and hesitation there may be in your own mind must never be communicated to theirs, not even (i would rather say especially not) in little things. let your doubt be to yourself, your decision to them. people who think outside their heads, the whole process of whose thought appears, like homer's, in the act of secretion, who tell everything that led them towards this conclusion and away from that, ought never to be with the sick. [sidenote: irresolution most painful to them.] irresolution is what all patients most dread. rather than meet this in others, they will collect all their data, and make up their minds for themselves. a change of mind in others, whether it is regarding an operation, or re-writing a letter, always injures the patient more than the being called upon to make up his mind to the most dreaded or difficult decision. farther than this, in very many cases, the imagination in disease is far more active and vivid than it is in health. if you propose to the patient change of air to one place one hour, and to another the next, he has, in each case, immediately constituted himself in imagination the tenant of the place, gone over the whole premises in idea, and you have tired him as much by displacing his imagination, as if you had actually carried him over both places. above all, leave the sick room quickly and come into it quickly, not suddenly, not with a rush. but don't let the patient be wearily waiting for when you will be out of the room or when you will be in it. conciseness and decision in your movements, as well as your words, are necessary in the sick room, as necessary as absence of hurry and bustle. to possess yourself entirely will ensure you from either failing--either loitering or hurrying. [sidenote: what a patient must not have to see to.] if a patient has to see, not only to his own but also to his nurse's punctuality, or perseverance, or readiness, or calmness, to any or all of these things, he is far better without that nurse than with her-- however valuable and handy her services may otherwise be to him, and however incapable he may be of rendering them to himself. [sidenote: reading aloud.] with regard to reading aloud in the sick room, my experience is, that when the sick are too ill to read to themselves, they can seldom bear to be read to. children, eye-patients, and uneducated persons are exceptions, or where there is any mechanical difficulty in reading. people who like to be read to, have generally not much the matter with them; while in fevers, or where there is much irritability of brain, the effort of listening to reading aloud has often brought on delirium. i speak with great diffidence; because there is an almost universal impression that it is _sparing_ the sick to read aloud to them. but two things are certain:-- [sidenote: read aloud slowly, distinctly, and steadily to the sick.] ( .) if there is some matter which _must_ be read to a sick person, do it slowly. people often think that the way to get it over with least fatigue to him is to get it over in least time. they gabble; they plunge and gallop through the reading. there never was a greater mistake. houdin, the conjuror, says that the way to make a story seem short is to tell it slowly. so it is with reading to the sick. i have often heard a patient say to such a mistaken reader, "don't read it to me; tell it me."[ ] unconsciously he is aware that this will regulate the plunging, the reading with unequal paces, slurring over one part, instead of leaving it out altogether, if it is unimportant, and mumbling another. if the reader lets his own attention wander, and then stops to read up to himself, or finds he has read the wrong bit, then it is all over with the poor patient's chance of not suffering. very few people know how to read to the sick; very few read aloud as pleasantly even as they speak. in reading they sing, they hesitate, they stammer, they hurry, they mumble; when in speaking they do none of these things. reading aloud to the sick ought always to be rather slow, and exceedingly distinct, but not mouthing--rather monotonous, but not sing song--rather loud but not noisy--and, above all, not too long. be very sure of what your patient can bear. [sidenote: never read aloud by fits and starts to the sick.] ( .) the extraordinary habit of reading to oneself in a sick room, and reading aloud to the patient any bits which will amuse him or more often the reader, is unaccountably thoughtless. what _do_ you think the patient is thinking of during your gaps of non-reading? do you think that he amuses himself upon what you have read for precisely the time it pleases you to go on reading to yourself, and that his attention is ready for something else at precisely the time it pleases you to begin reading again? whether the person thus read to be sick or well, whether he be doing nothing or doing something else while being thus read to, the self-absorption and want of observation of the person who does it, is equally difficult to understand--although very often the read_ee_ is too amiable to say how much it hurts him. [sidenote: people overhead.] one thing more:--from, the flimsy manner in which most modern houses are built, where every step on the stairs, and along the floors, is felt all over the house; the higher the story, the greater the vibration. it is inconceivable how much the sick suffer by having anybody overhead. in the solidly built old houses, which, fortunately, most hospitals are, the noise and shaking is comparatively trifling. but it is a serious cause of suffering, in lightly built houses, and with the irritability peculiar to some diseases. better far put such patients at the top of the house, even with the additional fatigue of stairs, if you cannot secure the room above them being untenanted; you may otherwise bring on a state of restlessness which no opium will subdue. do not neglect the warning, when a patient tells you that he "feels every step above him to cross his heart." remember that every noise a patient cannot _see_ partakes of the character of suddenness to him; and i am persuaded that patients with these peculiarly irritable nerves, are positively less injured by having persons in the same room with them than overhead, or separated by only a thin compartment. any sacrifice to secure silence for these cases is worth while, because no air, however good, no attendance, however careful, will do anything for such cases without quiet. [sidenote: music.] note.--the effect of music upon the sick has been scarcely at all noticed. in fact, its expensiveness, as it is now, makes any general application of it quite out of the question. i will only remark here, that wind instruments, including the human voice, and stringed instruments, capable of continuous sound, have generally a beneficent effect--while the piano-forte, with such instruments as have _no_ continuity of sound, has just the reverse. the finest piano-forte playing will damage the sick, while an air, like "home, sweet home," or "assisa a piè d'un salice," on the most ordinary grinding organ, will sensibly soothe them--and this quite independent of association. footnotes: [ ] [sidenote: burning of the crinolines.] fortunate it is if her skirts do not catch fire--and if the nurse does not give herself up a sacrifice together with her patient, to be burnt in her own petticoats. i wish the registrar-general would tell us the exact number of deaths by burning occasioned by this absurd and hideous custom. but if people will be stupid, let them take measures to protect themselves from their own stupidity--measures which every chemist knows, such as putting alum into starch, which prevents starched articles of dress from blazing up. [sidenote: indecency of the crinolines.] i wish, too, that people who wear crinoline could see the indecency of their own dress as other people see it. a respectable elderly woman stooping forward, invested in crinoline, exposes quite as much of her own person to the patient lying in the room as any opera dancer does on the stage. but no one will ever tell her this unpleasant truth. [ ] [sidenote: never speak to a patient in the act of moving.] it is absolutely essential that a nurse should lay this down as a positive rule to herself, never to speak to any patient who is standing or moving, as long as she exercises so little observation as not to know when a patient cannot bear it. i am satisfied that many of the accidents which happen from feeble patients tumbling down stairs, fainting after getting up, &c., happen solely from the nurse popping out of a door to speak to the patient just at that moment; or from his fearing that she will do so. and that if the patient were even left to himself, till he can sit down, such accidents would much seldomer occur. if the nurse accompanies the patient, let her not call upon him to speak. it is incredible that nurses cannot picture to themselves the strain upon the heart, the lungs, and the brain, which the act of moving is to any feeble patient. [ ] [sidenote: careless observation of the results of careless visits.] as an old experienced nurse, i do most earnestly deprecate all such careless words. i have known patients delirious all night, after seeing a visitor who called them "better," thought they "only wanted a little amusement," and who came again, saying, "i hope you were not the worse for my visit," neither waiting for an answer, nor even looking at the case. no real patient will ever say, "yes, but i was a great deal the worse." it is not, however, either death or delirium of which, in these cases, there is most danger to the patient. unperceived consequences are far more likely to ensue. _you_ will have impunity--the poor patient will _not_. that is, the patient will suffer, although neither he nor the inflictor of the injury will attribute it to its real cause. it will not be directly traceable, except by a very careful observant nurse. the patient will often not even mention what has done him most harm. [ ] [sidenote: the sick would rather be told a thing than have it read to them.] sick children, if not too shy to speak, will always express this wish. they invariably prefer a story to be _told_ to them, rather than read to them. v. variety. [sidenote: variety a means of recovery.] to any but an old nurse, or an old patient, the degree would be quite inconceivable to which the nerves of the sick suffer from seeing the same walls, the same ceiling, the same surroundings during a long confinement to one or two rooms. the superior cheerfulness of persons suffering severe paroxysms of pain over that of persons suffering from nervous debility has often been remarked upon, and attributed to the enjoyment of the former of their intervals of respite. i incline to think that the majority of cheerful cases is to be found among those patients who are not confined to one room, whatever their suffering, and that the majority of depressed cases will be seen among those subjected to a long monotony of objects about them. the nervous frame really suffers as much from this as the digestive organs from long monotony of diet, as e.g. the soldier from his twenty-one years' "boiled beef." [sidenote: colour and form means of recovery.] the effect in sickness of beautiful objects, of variety of objects, and especially of brilliancy of colour is hardly at all appreciated. such cravings are usually called the "fancies" of patients. and often doubtless patients have "fancies," as e.g. when they desire two contradictions. but much more often, their (so called) "fancies" are the most valuable indications of what is necessary for their recovery. and it would be well if nurses would watch these (so called) "fancies" closely. i have seen, in fevers (and felt, when i was a fever patient myself), the most acute suffering produced from the patient (in a hut) not being able to see out of window, and the knots in the wood being the only view. i shall never forget the rapture of fever patients over a bunch of bright-coloured flowers. i remember (in my own case) a nosegay of wild flowers being sent me, and from that moment recovery becoming more rapid. [sidenote: this is no fancy.] people say the effect is only on the mind. it is no such thing. the effect is on the body, too. little as we know about the way in which we are affected by form, by colour, and light, we do know this, that they have an actual physical effect. variety of form and brilliancy of colour in the objects presented to patients are actual means of recovery. but it must be _slow_ variety, e.g., if you shew a patient ten or twelve engravings successively, ten-to-one that he does not become cold and faint, or feverish, or even sick; but hang one up opposite him, one on each successive day, or week, or month, and he will revel in the variety. [sidenote: flowers.] the folly and ignorance which reign too often supreme over the sick-room, cannot be better exemplified than by this. while the nurse will leave the patient stewing in a corrupting atmosphere, the best ingredient of which is carbonic acid; she will deny him, on the plea of unhealthiness, a glass of cut-flowers, or a growing plant. now, no one ever saw "overcrowding" by plants in a room or ward. and the carbonic acid they give off at nights would not poison a fly. nay, in overcrowded rooms, they actually absorb carbonic acid and give off oxygen. cut-flowers also decompose water and produce oxygen gas. it is true there are certain flowers, e.g. lilies, the smell of which is said to depress the nervous system. these are easily known by the smell, and can be avoided. [sidenote: effect of body on mind.] volumes are now written and spoken upon the effect of the mind upon the body. much of it is true. but i wish a little more was thought of the effect of the body on the mind. you who believe yourselves overwhelmed with anxieties, but are able every day to walk up regent-street, or out in the country, to take your meals with others in other rooms, &c., &c., you little know how much your anxieties are thereby lightened; you little know how intensified they become to those who can have no change;[ ] how the very walls of their sick rooms seem hung with their cares; how the ghosts of their troubles haunt their beds; how impossible it is for them to escape from a pursuing thought without some help from variety. a patient can just as much move his leg when it is fractured as change his thoughts when no external help from variety is given him. this is, indeed, one of the main sufferings of sickness; just as the fixed posture is one of the main sufferings of the broken limb. [sidenote: help the sick to vary their thoughts.] it is an ever recurring wonder to see educated people, who call themselves nurses, acting thus. they vary their own objects, their own employments, many times a day; and while nursing (!) some bed-ridden sufferer, they let him lie there staring at a dead wall, without any change of object to enable him to vary his thoughts; and it never even occurs to them, at least to move his bed so that he can look out of window. no, the bed is to be always left in the darkest, dullest, remotest, part of the room.[ ] i think it is a very common error among the well to think that "with a little more self-control" the sick might, if they choose, "dismiss painful thoughts" which "aggravate their disease," &c. believe me, almost _any_ sick person, who behaves decently well, exercises more self-control every moment of his day than you will ever know till you are sick yourself. almost every step that crosses his room is painful to him; almost every thought that crosses his brain is painful to him: and if he can speak without being savage, and look without being unpleasant, he is exercising self-control. suppose you have been up all night, and instead of being allowed to have your cup of tea, you were to be told that you ought to "exercise self-control," what should you say? now, the nerves of the sick are always in the state that yours are in after you have been up all night. [sidenote: supply to the sick the defect of manual labour.] we will suppose the diet of the sick to be cared for. then, this state of nerves is most frequently to be relieved by care in affording them a pleasant view, a judicious variety as to flowers,[ ] and pretty things. light by itself will often relieve it. the craving for "the return of day," which the sick so constantly evince, is generally nothing but the desire for light, the remembrance of the relief which a variety of objects before the eye affords to the harassed sick mind. again, every man and every woman has some amount of manual employment, excepting a few fine ladies, who do not even dress themselves, and who are virtually in the same category, as to nerves, as the sick. now, you can have no idea of the relief which manual labour is to you--of the degree to which the deprivation of manual employment increases the peculiar irritability from which many sick suffer. a little needle-work, a little writing, a little cleaning, would be the greatest relief the sick could have, if they could do it; these _are_ the greatest relief to you, though you do not know it. reading, though it is often the only thing the sick can do, is not this relief. bearing this in mind, bearing in mind that you have all these varieties of employment which the sick cannot have, bear also in mind to obtain for them all the varieties which they can enjoy. i need hardly say that i am well aware that excess in needle-work, in writing, in any other continuous employment, will produce the same irritability that defect in manual employment (as one cause) produces in the sick. footnotes: [ ] [sidenote: sick suffer to excess from mental as well as bodily pain.] it is a matter of painful wonder to the sick themselves, how much painful ideas predominate over pleasurable ones in their impressions; they reason with themselves; they think themselves ungrateful; it is all of no use. the fact is, that these painful impressions are far better dismissed by a real laugh, if you can excite one by books or conversation, than by any direct reasoning; or if the patient is too weak to laugh, some impression from nature is what he wants. i have mentioned the cruelty of letting him stare at a dead wall. in many diseases, especially in convalescence from fever, that wall will appear to make all sorts of faces at him; now flowers never do this. form, colour, will free your patient from his painful ideas better than any argument. [ ] [sidenote: desperate desire in the sick to "see out of window."] i remember a case in point. a man received an injury to the spine, from an accident, which after a long confinement ended in death. he was a workman--had not in his composition a single grain of what is called "enthusiasm for nature"--but he was desperate to "see once more out of window." his nurse actually got him on her back, and managed to perch him up at the window for an instant, "to see out." the consequence to the poor nurse was a serious illness, which nearly proved fatal. the man never knew it; but a great many other people did. yet the consequence in none of their minds, so far as i know, was the conviction that the craving for variety in the starving eye, is just as desperate as that of food in the starving stomach, and tempts the famishing creature in either case to steal for its satisfaction. no other word will express it but "desperation." and it sets the seal of ignorance and stupidity just as much on the governors and attendants of the sick if they do not provide the sick-bed with a "view" of some kind, as if they did not provide the hospital with a kitchen. [ ] [sidenote: physical effect of colour.] no one who has watched the sick can doubt the fact, that some feel stimulus from looking at scarlet flowers, exhaustion from looking at deep blue, &c. vi. taking food. [sidenote: want of attention to hours of taking food.] every careful observer of the sick will agree in this that thousands of patients are annually starved in the midst of plenty, from want of attention to the ways which alone make it possible for them to take food. this want of attention is as remarkable in those who urge upon the sick to do what is quite impossible to them, as in the sick themselves who will not make the effort to do what is perfectly possible to them. for instance, to the large majority of very weak patients it is quite impossible to take any solid food before a.m., nor then, if their strength is still further exhausted by fasting till that hour. for weak patients have generally feverish nights and, in the morning, dry mouths; and, if they could eat with those dry mouths, it would be the worse for them. a spoonful of beef-tea, of arrowroot and wine, of egg flip, every hour, will give them the requisite nourishment, and prevent them from being too much exhausted to take at a later hour the solid food, which is necessary for their recovery. and every patient who can swallow at all can swallow these liquid things, if he chooses. but how often do we hear a mutton-chop, an egg, a bit of bacon, ordered to a patient for breakfast, to whom (as a moment's consideration would show us) it must be quite impossible to masticate such things at that hour. again, a nurse is ordered to give a patient a tea-cup full of some article of food every three hours. the patient's stomach rejects it. if so, try a table-spoon full every hour; if this will not do, a tea-spoon full every quarter of an hour. i am bound to say, that i think more patients are lost by want of care and ingenuity in these momentous minutiae in private nursing than in public hospitals. and i think there is more of the _entente cordiale_ to assist one another's hands between the doctor and his head nurse in the latter institutions, than between the doctor and the patient's friends in the private house. [sidenote: life often hangs upon minutes in taking food.] if we did but know the consequences which may ensue, in very weak patients, from ten minutes' fasting or repletion (i call it repletion when they are obliged to let too small an interval elapse between taking food and some other exertion, owing to the nurse's unpunctuality), we should be more careful never to let this occur. in very weak patients there is often a nervous difficulty of swallowing, which is so much increased by any other call upon their strength that, unless they have their food punctually at the minute, which minute again must be arranged so as to fall in with no other minute's occupation, they can take nothing till the next respite occurs--so that an unpunctuality or delay of ten minutes may very well turn out to be one of two or three hours. and why is it not as easy to be punctual to a minute? life often literally hangs upon these minutes. in acute cases, where life or death is to be determined in a few hours, these matters are very generally attended to, especially in hospitals; and the number of cases is large where the patient is, as it were, brought back to life by exceeding care on the part of the doctor or nurse, or both, in ordering and giving nourishment with minute selection and punctuality. [sidenote: patients often starved to death in chronic cases.] but in chronic cases, lasting over months and years, where the fatal issue is often determined at last by mere protracted starvation, i had rather not enumerate the instances which i have known where a little ingenuity, and a great deal of perseverance, might, in all probability, have averted the result. the consulting the hours when the patient can take food, the observation of the times, often varying, when he is most faint, the altering seasons of taking food, in order to anticipate and prevent such times--all this, which requires observation, ingenuity, and perseverance (and these really constitute the good nurse), might save more lives than we wot of. [sidenote: food never to be left by the patient's side.] to leave the patient's untasted food by his side, from meal to meal, in hopes that he will eat it in the interval is simply to prevent him from taking any food at all. i have known patients literally incapacitated from taking one article of food after another, by this piece of ignorance. let the food come at the right time, and be taken away, eaten or uneaten, at the right time; but never let a patient have "something always standing" by him, if you don't wish to disgust him of everything. on the other hand, i have known a patient's life saved (he was sinking for want of food) by the simple question, put to him by the doctor, "but is there no hour when you feel you could eat?" "oh, yes," he said, "i could always take something at ---- o'clock and ---- o'clock." the thing was tried and succeeded. patients very seldom, however, can tell this; it is for you to watch and find it out. [sidenote: patient had better not see more food than his own.] a patient should, if possible, not see or smell either the food of others, or a greater amount of food than he himself can consume at one time, or even hear food talked about or see it in the raw state. i know of no exception to the above rule. the breaking of it always induces a greater or less incapacity of taking food. in hospital wards it is of course impossible to observe all this; and in single wards, where a patient must be continuously and closely watched, it is frequently impossible to relieve the attendant, so that his or her own meals can be taken out of the ward. but it is not the less true that, in such cases, even where the patient is not himself aware of it, his possibility of taking food is limited by seeing the attendant eating meals under his observation. in some cases the sick are aware of it, and complain. a case where the patient was supposed to be insensible, but complained as soon as able to speak, is now present to my recollection. remember, however, that the extreme punctuality in well-ordered hospitals, the rule that nothing shall be done in the ward while the patients are having their meals, go far to counterbalance what unavoidable evil there is in having patients together. i have often seen the private nurse go on dusting or fidgeting about in a sick room all the while the patient is eating, or trying to eat. that the more alone an invalid can be when taking food, the better, is unquestionable; and, even if he must be fed, the nurse should not allow him to talk, or talk to him, especially about food, while eating. when a person is compelled, by the pressure of occupation, to continue his business while sick, it ought to be a rule without any exception whatever, that no one shall bring business to him or talk to him while he is taking food, nor go on talking to him on interesting subjects up to the last moment before his meals, nor make an engagement with him immediately after, so that there be any hurry of mind while taking them. upon the observance of these rules, especially the first, often depends the patient's capability of taking food at all, or, if he is amiable and forces himself to take food, of deriving any nourishment from it. [sidenote: you cannot be too careful as to quality in sick diet.] a nurse should never put before a patient milk that is sour, meat or soup that is turned, an egg that is bad, or vegetables underdone. yet often i have seen these things brought in to the sick in a state perfectly perceptible to every nose or eye except the nurse's. it is here that the clever nurse appears; she will not bring in the peccant article, but, not to disappoint the patient, she will whip up something else in a few minutes. remember that sick cookery should half do the work of your poor patient's weak digestion. but if you further impair it with your bad articles, i know not what is to become of him or of it. if the nurse is an intelligent being, and not a mere carrier of diets to and from the patient, let her exercise her intelligence in these things. how often we have known a patient eat nothing at all in the day, because one meal was left untasted (at that time he was incapable of eating), at another the milk was sour, the third was spoiled by some other accident. and it never occurred to the nurse to extemporize some expedient,--it never occurred to her that as he had had no solid food that day he might eat a bit of toast (say) with his tea in the evening, or he might have some meal an hour earlier. a patient who cannot touch his dinner at two, will often accept it gladly, if brought to him at seven. but somehow nurses never "think of these things." one would imagine they did not consider themselves bound to exercise their judgment; they leave it to the patient. now i am quite sure that it is better for a patient rather to suffer these neglects than to try to teach his nurse to nurse him, if she does not know how. it ruffles him, and if he is ill he is in no condition to teach, especially upon himself. the above remarks apply much more to private nursing than to hospitals. [sidenote: nurse must have some rule of thought about her patient's diet.] i would say to the nurse, have a rule of thought about your patient's diet; consider, remember how much he has had, and how much he ought to have to-day. generally, the only rule of the private patient's diet is what the nurse has to give. it is true she cannot give him what she has not got; but his stomach does not wait for her convenience, or even her necessity.[ ] if it is used to having its stimulus at one hour to-day, and to-morrow it does not have it, because she has failed in getting it, he will suffer. she must be always exercising her ingenuity to supply defects, and to remedy accidents which will happen among the best contrivers, but from which the patient does not suffer the less, because "they cannot be helped." [sidenote: keep your patient's cup dry underneath.] one very minute caution,--take care not to spill into your patient's saucer, in other words, take care that the outside bottom rim of his cup shall be quite dry and clean; if, every time he lifts his cup to his lips, he has to carry the saucer with it, or else to drop the liquid upon, and to soil his sheet, or his bed-gown, or pillow, or if he is sitting up, his dress, you have no idea what a difference this minute want of care on your part makes to his comfort and even to his willingness for food. footnote: [ ] [sidenote: nurse must have some rule of time about the patient's diet.] why, because the nurse has not got some food to-day which the patient takes, can the patient wait four hours for food to-day, who could not wait two hours yesterday? yet this is the only logic one generally hears. on the other hand, the other logic, viz., of the nurse giving a patient a thing because she _has_ got it, is equally fatal. if she happens to have fresh jelly, or fresh fruit, she will frequently give it to the patient half an hour after his dinner, or at his dinner, when he cannot possibly eat that and the broth too--or worse still, leave it by his bed-side till he is so sickened with the sight of it, that he cannot eat it at all. vii. what food? [sidenote: common errors in diet.] [sidenote: beef tea.] [sidenote: eggs.] [sidenote: meat without vegetables.] [sidenote: arrowroot.] i will mention one or two of the most common errors among women in charge of sick respecting sick diet. one is the belief that beef tea is the most nutritive of all articles. now, just try and boil down a lb. of beef into beef tea, evaporate your beef tea, and see what is left of your beef. you will find that there is barely a teaspoonful of solid nourishment to half a pint of water in beef tea;--nevertheless there is a certain reparative quality in it, we do not know what, as there is in tea;--but it may safely be given in almost any inflammatory disease, and is as little to be depended upon with the healthy or convalescent where much nourishment is required. again, it is an ever ready saw that an egg is equivalent to a lb. of meat,--whereas it is not at all so. also, it is seldom noticed with how many patients, particularly of nervous or bilious temperament, eggs disagree. all puddings made with eggs, are distasteful to them in consequence. an egg, whipped up with wine, is often the only form in which they can take this kind of nourishment. again, if the patient has attained to eating meat, it is supposed that to give him meat is the only thing needful for his recovery; whereas scorbutic sores have been actually known to appear among sick persons living in the midst of plenty in england, which could be traced to no other source than this, viz.: that the nurse, depending on meat alone, had allowed the patient to be without vegetables for a considerable time, these latter being so badly cooked that he always left them untouched. arrowroot is another grand dependence of the nurse. as a vehicle for wine, and as a restorative quickly prepared, it is all very well. but it is nothing but starch and water. flour is both more nutritive, and less liable to ferment, and is preferable wherever it can be used. [sidenote: milk, butter, cream, &c.] again, milk and the preparations from milk, are a most important article of food for the sick. butter is the lightest kind of animal fat, and though it wants the sugar and some of the other elements which there are in milk, yet it is most valuable both in itself and in enabling the patient to eat more bread. flour, oats, groats, barley, and their kind, are, as we have already said, preferable in all their preparations to all the preparations of arrowroot, sago, tapioca, and their kind. cream, in many long chronic diseases, is quite irreplaceable by any other article whatever. it seems to act in the same manner as beef tea, and to most it is much easier of digestion than milk. in fact, it seldom disagrees. cheese is not usually digestible by the sick, but it is pure nourishment for repairing waste; and i have seen sick, and not a few either, whose craving for cheese shewed how much it was needed by them.[ ] but, if fresh milk is so valuable a food for the sick, the least change or sourness in it, makes it of all articles, perhaps, the most injurious; diarrhoea is a common result of fresh milk allowed to become at all sour. the nurse therefore ought to exercise her utmost care in this. in large institutions for the sick, even the poorest, the utmost care is exercised. wenham lake ice is used for this express purpose every summer, while the private patient, perhaps, never tastes a drop of milk that is not sour, all through the hot weather, so little does the private nurse understand the necessity of such care. yet, if you consider that the only drop of real nourishment in your patient's tea is the drop of milk, and how much almost all english patients depend upon their tea, you will see the great importance of not depriving your patient of this drop of milk. buttermilk, a totally different thing, is often very useful, especially in fevers. [sidenote: sweet things.] in laying down rules of diet, by the amounts of "solid nutriment" in different kinds of food, it is constantly lost sight of what the patient requires to repair his waste, what he can take and what he can't. you cannot diet a patient from a book, you cannot make up the human body as you would make up a prescription,--so many parts "carboniferous," so many parts "nitrogenous" will constitute a perfect diet for the patient. the nurse's observation here will materially assist the doctor--the patient's "fancies" will materially assist the nurse. for instance, sugar is one of the most nutritive of all articles, being pure carbon, and is particularly recommended in some books. but the vast majority of all patients in england, young and old, male and female, rich and poor, hospital and private, dislike sweet things,--and while i have never known a person take to sweets when he was ill who disliked them when he was well, i have known many fond of them when in health, who in sickness would leave off anything sweet, even to sugar in tea,--sweet puddings, sweet drinks, are their aversion; the furred tongue almost always likes what is sharp or pungent. scorbutic patients are an exception, they often crave for sweetmeats and jams. [sidenote: jelly.] jelly is another article of diet in great favour with nurses and friends of the sick; even if it could be eaten solid, it would not nourish, but it is simply the height of folly to take / oz. of gelatine and make it into a certain bulk by dissolving it in water and then to give it to the sick, as if the mere bulk represented nourishment. it is now known that jelly does not nourish, that it has a tendency to produce diarrhoea,-- and to trust to it to repair the waste of a diseased constitution is simply to starve the sick under the guise of feeding them. if spoonfuls of jelly were given in the course of the day, you would have given one spoonful of gelatine, which spoonful has no nutritive power whatever. and, nevertheless, gelatine contains a large quantity of nitrogen, which is one of the most powerful elements in nutrition; on the other hand, beef tea may be chosen as an illustration of great nutrient power in sickness, co-existing with a very small amount of solid nitrogenous matter. [sidenote: beef tea] dr. christison says that "every one will be struck with the readiness with which" certain classes of "patients will often take diluted meat juice or beef tea repeatedly, when they refuse all other kinds of food." this is particularly remarkable in "cases of gastric fever, in which," he says, "little or nothing else besides beef tea or diluted meat juice" has been taken for weeks or even months, "and yet a pint of beef tea contains scarcely / oz. of anything but water,"--the result is so striking that he asks what is its mode of action? "not simply nutrient-- / oz. of the most nutritive material cannot nearly replace the daily wear and tear of the tissues in any circumstances. possibly," he says, "it belongs to a new denomination of remedies." it has been observed that a small quantity of beef tea added to other articles of nutrition augments their power out of all proportion to the additional amount of solid matter. the reason why jelly should be innutritious and beef tea nutritious to the sick, is a secret yet undiscovered, but it clearly shows that careful observation of the sick is the only clue to the best dietary. [sidenote: observation, not chemistry, must decide sick diet.] chemistry has as yet afforded little insight into the dieting of sick. all that chemistry can tell us is the amount of "carboniferous" or "nitrogenous" elements discoverable in different dietetic articles. it has given us lists of dietetic substances, arranged in the order of their richness in one or other of these principles; but that is all. in the great majority of cases, the stomach of the patient is guided by other principles of selection than merely the amount of carbon or nitrogen in the diet. no doubt, in this as in other things, nature has very definite rules for her guidance, but these rules can only be ascertained by the most careful observation at the bedside. she there teaches us that living chemistry, the chemistry of reparation, is something different from the chemistry of the laboratory. organic chemistry is useful, as all knowledge is, when we come face to face with nature; but it by no means follows that we should learn in the laboratory any one of the reparative processes going on in disease. again, the nutritive power of milk and of the preparations from milk, is very much undervalued; there is nearly as much nourishment in half a pint of milk as there is in a quarter of a lb. of meat. but this is not the whole question or nearly the whole. the main question is what the patient's stomach can assimilate or derive nourishment from, and of this the patient's stomach is the sole judge. chemistry cannot tell this. the patient's stomach must be its own chemist. the diet which will keep the healthy man healthy, will kill the sick one. the same beef which is the most nutritive of all meat and which nourishes the healthy man, is the least nourishing of all food to the sick man, whose half-dead stomach can _assimilate_ no part of it, that is, make no food out of it. on a diet of beef tea healthy men on the other hand speedily lose their strength. [sidenote: home-made bread.] i have known patients live for many months without touching bread, because they could not eat baker's bread. these were mostly country patients, but not all. home-made bread or brown bread is a most important article of diet for many patients. the use of aperients may be entirely superseded by it. oat cake is another. [sidenote: sound observation has scarcely yet been brought to bear on sick diet.] to watch for the opinions, then, which the patient's stomach gives, rather than to read "analyses of foods," is the business of all those who have to settle what the patient is to eat--perhaps the most important thing to be provided for him after the air he is to breathe. now the medical man who sees the patient only once a day or even only once or twice a week, cannot possibly tell this without the assistance of the patient himself, or of those who are in constant observation on the patient. the utmost the medical man can tell is whether the patient is weaker or stronger at this visit than he was at the last visit. i should therefore say that incomparably the most important office of the nurse, after she has taken care of the patient's air, is to take care to observe the effect of his food, and report it to the medical attendant. it is quite incalculable the good that would certainly come from such _sound_ and close observation in this almost neglected branch of nursing, or the help it would give to the medical man. [sidenote: tea and coffee.] a great deal too much against tea[ ] is said by wise people, and a great deal too much of tea is given to the sick by foolish people. when you see the natural and almost universal craving in english sick for their "tea," you cannot but feel that nature knows what she is about. but a little tea or coffee restores them quite as much as a great deal, and a great deal of tea and especially of coffee impairs the little power of digestion they have. yet a nurse, because she sees how one or two cups of tea or coffee restores her patient, thinks that three or four cups will do twice as much. this is not the case at all; it is however certain that there is nothing yet discovered which is a substitute to the english patient for his cup of tea; he can take it when he can take nothing else, and he often can't take anything else if he has it not. i should be very glad if any of the abusers of tea would point out what to give to an english patient after a sleepless night, instead of tea. if you give it at or o'clock in the morning, he may even sometimes fall asleep after it, and get perhaps his only two or three hours' sleep during the twenty-four. at the same time you never should give tea or coffee to the sick, as a rule, after o'clock in the afternoon. sleeplessness in the early night is from excitement generally and is increased by tea or coffee; sleeplessness which continues to the early morning is from exhaustion often, and is relieved by tea. the only english patients i have ever known refuse tea, have been typhus cases, and the first sign of their getting better was their craving again for tea. in general, the dry and dirty tongue always prefers tea to coffee, and will quite decline milk, unless with tea. coffee is a better restorative than tea, but a greater impairer of the digestion. let the patient's taste decide. you will say that, in cases of great thirst, the patient's craving decides that it will drink _a great deal_ of tea, and that you cannot help it. but in these cases be sure that the patient requires diluents for quite other purposes than quenching the thirst; he wants a great deal of some drink, not only of tea, and the doctor will order what he is to have, barley water or lemonade, or soda water and milk, as the case may be. lehman, quoted by dr. christison, says that, among the well and active "the infusion of oz. of roasted coffee daily will diminish the waste" going on in the body" "by one-fourth," [transcriber's note: quotes as in the original] and dr. christison adds that tea has the same property. now this is actual experiment. lehman weighs the man and finds the fact from his weight. it is not deduced from any "analysis" of food. all experience among the sick shows the same thing.[ ] [sidenote: cocoa.] cocoa is often recommended to the sick in lieu of tea or coffee. but independently of the fact that english sick very generally dislike cocoa, it has quite a different effect from tea or coffee. it is an oily starchy nut having no restorative power at all, but simply increasing fat. it is pure mockery of the sick, therefore, to call it a substitute for tea. for any renovating stimulus it has, you might just as well offer them chestnuts instead of tea. [sidenote: bulk.] an almost universal error among nurses is in the bulk of the food and especially the drinks they offer to their patients. suppose a patient ordered oz. brandy during the day, how is he to take this if you make it into four pints with diluting it? the same with tea and beef tea, with arrowroot, milk, &c. you have not increased the nourishment, you have not increased the renovating power of these articles, by increasing their bulk,--you have very likely diminished both by giving the patient's digestion more to do, and most likely of all, the patient will leave half of what he has been ordered to take, because he cannot swallow the bulk with which you have been pleased to invest it. it requires very nice observation and care (and meets with hardly any) to determine what will not be too thick or strong for the patient to take, while giving him no more than the bulk which he is able to swallow. footnotes: [ ] [sidenote: intelligent cravings of particular sick for particular articles of diet.] in the diseases produced by bad food, such as scorbutic dysentery and diarrhoea, the patient's stomach often craves for and digests things, some of which certainly would be laid down in no dietary that ever was invented for sick, and especially not for such sick. these are fruit, pickles, jams, gingerbread, fat of ham or bacon, suet, cheese, butter, milk. these cases i have seen not by ones, nor by tens, but by hundreds. and the patient's stomach was right and the book was wrong. the articles craved for, in these cases, might have been principally arranged under the two heads of fat and vegetable acids. there is often a marked difference between men and women in this matter of sick feeding. women's digestion is generally slower. [ ] it is made a frequent recommendation to persons about to incur great exhaustion, either from the nature of the service, or from their being not in a state fit for it, to eat a piece of bread before they go. i wish the recommenders would themselves try the experiment of substituting a piece of bread for a cup of tea or coffee, or beef-tea, as a refresher. they would find it a very poor comfort. when soldiers have to set out fasting on fatiguing duty, when nurses have to go fasting in to their patients, it is a hot restorative they want, and ought to have, before they go, not a cold bit of bread. and dreadful have been the consequences of neglecting this. if they can take a bit of bread _with_ the hot cup of tea, so much the better, but not _instead_ of it. the fact that there is more nourishment in bread than in almost anything else, has probably induced the mistake. that it is a fatal mistake, there is no doubt. it seems, though very little is known on the subject, that what "assimilates" itself directly, and with the least trouble of digestion with the human body, is the best for the above circumstances. bread requires two or three processes of assimilation, before it becomes like the human body. the almost universal testimony of english men and women who have undergone great fatigue, such as riding long journeys without stopping, or sitting up for several nights in succession, is that they could do it best upon an occasional cup of tea--and nothing else. let experience, not theory, decide upon this as upon all other things. [ ] in making coffee, it is absolutely necessary to buy it in the berry and grind it at home. otherwise you may reckon upon its containing a certain amount of chicory, _at least_. this is not a question of the taste, or of the wholesomeness of chicory. it is that chicory has nothing at all of the properties for which you give coffee. and therefore you may as well not give it. again, all laundresses, mistresses of dairy-farms, head nurses, (i speak of the good old sort only--women who unite a good deal of hard manual labour with the head-work necessary for arranging the day's business, so that none of it shall tread upon the heels of something else,) set great value, i have observed, upon having a high-priced tea. this is called extravagant. but these women are "extravagant" in nothing else. and they are right in this. real tea-leaf tea alone contains the restorative they want; which is not to be found in sloe-leaf tea. the mistresses of houses, who cannot even go over their own house once a day, are incapable of judging for these women. for they are incapable themselves, to all appearance, of the spirit of arrangement (no small task) necessary for managing a large ward or dairy. viii. bed and bedding. [sidenote: feverishness a symptom of bedding.] a few words upon bedsteads and bedding; and principally as regards patients who are entirely, or almost entirely, confined to bed. feverishness is generally supposed to be a symptom of fever--in nine cases out of ten it is a symptom of bedding.[ ] the patient has had re-introduced into the body the emanations from himself which day after day and week after week saturate his unaired bedding. how can it be otherwise? look at the ordinary bed in which a patient lies. [sidenote: uncleanliness of ordinary bedding.] if i were looking out for an example in order to show what _not_ to do, i should take the specimen of an ordinary bed in a private house: a wooden bedstead, two or even three mattresses piled up to above the height of a table; a vallance attached to the frame--nothing but a miracle could ever thoroughly dry or air such a bed and bedding. the patient must inevitably alternate between cold damp after his bed is made, and warm damp before, both saturated with organic matter[ ], and this from the time the mattresses are put under him till the time they are picked to pieces, if this is ever done. [sidenote: air your dirty sheets, not only your clean ones.] if you consider that an adult in health exhales by the lungs and skin in the twenty-four hours three pints at least of moisture, loaded with organic matter ready to enter into putrefaction; that in sickness the quantity is often greatly increased, the quality is always more noxious --just ask yourself next where does all this moisture go to? chiefly into the bedding, because it cannot go anywhere else. and it stays there; because, except perhaps a weekly change of sheets, scarcely any other airing is attempted. a nurse will be careful to fidgetiness about airing the clean sheets from clean damp, but airing the dirty sheets from noxious damp will never even occur to her. besides this, the most dangerous effluvia we know of are from the excreta of the sick--these are placed, at least temporarily, where they must throw their effluvia into the under side of the bed, and the space under the bed is never aired; it cannot be, with our arrangements. must not such a bed be always saturated, and be always the means of re-introducing into the system of the unfortunate patient who lies in it, that excrementitious matter to eliminate which from the body nature had expressly appointed the disease? my heart always sinks within me when i hear the good house-wife, of every class, say, "i assure you the bed has been well slept in," and i can only hope it is not true. what? is the bed already saturated with somebody else's damp before my patient comes to exhale in it his own damp? has it not had a single chance to be aired? no, not one. "it has been slept in every night." [sidenote: iron spring bedsteads the best.] [sidenote: comfort and cleanliness of _two_ beds.] the only way of really nursing a real patient is to have an _iron_ bedstead, with rheocline springs, which are permeable by the air up to the very mattress (no vallance, of course), the mattress to be a thin hair one; the bed to be not above - / feet wide. if the patient be entirely confined to his bed, there should be _two_ such bedsteads; each bed to be "made" with mattress, sheets, blankets, &c., complete--the patient to pass twelve hours in each bed; on no account to carry his sheets with him. the whole of the bedding to be hung up to air for each intermediate twelve hours. of course there are many cases where this cannot be done at all--many more where only an approach to it can be made. i am indicating the ideal of nursing, and what i have actually had done. but about the kind of bedstead there can be no doubt, whether there be one or two provided. [sidenote: bed not to be too wide.] there is a prejudice in favour of a wide bed--i believe it to be a prejudice. all the refreshment of moving a patient from one side to the other of his bed is far more effectually secured by putting him into a fresh bed; and a patient who is really very ill does not stray far in bed. but it is said there is no room to put a tray down on a narrow bed. no good nurse will ever put a tray on a bed at all. if the patient can turn on his side, he will eat more comfortably from a bed-side table; and on no account whatever should a bed ever be higher than a sofa. otherwise the patient feels himself "out of humanity's reach;" he can get at nothing for himself: he can move nothing for himself. if the patient cannot turn, a table over the bed is a better thing. i need hardly say that a patient's bed should never have its side against the wall. the nurse must be able to get easily to both sides of the bed, and to reach easily every part of the patient without stretching--a thing impossible if the bed be either too wide or too high. [sidenote: bed not to be too high.] when i see a patient in a room nine or ten feet high upon a bed between four and five feet high, with his head, when he is sitting up in bed, actually within two or three feet of the ceiling, i ask myself, is this expressly planned to produce that peculiarly distressing feeling common to the sick, viz., as if the walls and ceiling were closing in upon them, and they becoming sandwiches between floor and ceiling, which imagination is not, indeed, here so far from the truth? if, over and above this, the window stops short of the ceiling, then the patient's head may literally be raised above the stratum of fresh air, even when the window is open. can human perversity any farther go, in unmaking the process of restoration which god has made? the fact is, that the heads of sleepers or of sick should never be higher than the throat of the chimney, which ensures their being in the current of best air. and we will not suppose it possible that you have closed your chimney with a chimney-board. if a bed is higher than a sofa, the difference of the fatigue of getting in and out of bed will just make the difference, very often, to the patient (who can get in and out of bed at all) of being able to take a few minutes' exercise, either in the open air or in another room. it is so very odd that people never think of this, or of how many more times a patient who is in bed for the twenty-four hours is obliged to get in and out of bed than they are, who only, it is to be hoped, get into bed once and out of bed once during the twenty-four hours. [sidenote: nor in a dark place.] a patient's bed should always be in the lightest spot in the room; and he should be able to see out of window. [sidenote: nor a four poster with curtains.] i need scarcely say that the old four-post bed with curtains is utterly inadmissible, whether for sick or well. hospital bedsteads are in many respects very much less objectionable than private ones. [sidenote: scrofula often a result of disposition of bed clothes.] there is reason to believe that not a few of the apparently unaccountable cases of scrofula among children proceed from the habit of sleeping with the head under the bed clothes, and so inhaling air already breathed, which is farther contaminated by exhalations from the skin. patients are sometimes given to a similar habit, and it often happens that the bed clothes are so disposed that the patient must necessarily breathe air more or less contaminated by exhalations from his skin. a good nurse will be careful to attend to this. it is an important part, so to speak, of ventilation. [sidenote: bed sores.] it may be worth while to remark, that where there is any danger of bed-sores a blanket should never be placed _under_ the patient. it retains damp and acts like a poultice. [sidenote: heavy and impervious bed clothes.] never use anything but light whitney blankets as bed covering for the sick. the heavy cotton impervious counterpane is bad, for the very reason that it keeps in the emanations from the sick person, while the blanket allows them to pass through. weak patients are invariably distressed by a great weight of bed clothes, which often prevents their getting any sound sleep whatever. note.--one word about pillows. every weak patient, be his illness what it may, suffers more or less from difficulty in breathing. to take the weight of the body off the poor chest, which is hardly up to its work as it is, ought therefore to be the object of the nurse in arranging his pillows. now what does she do and what are the consequences? she piles the pillows one a-top of the other like a wall of bricks. the head is thrown upon the chest. and the shoulders are pushed forward, so as not to allow the lungs room to expand. the pillows, in fact, lean upon the patient, not the patient upon the pillows. it is impossible to give a rule for this, because it must vary with the figure of the patient. and tall patients suffer much more than short ones, because of the _drag_ of the long limbs upon the waist. but the object is to support, with the pillows, the back _below_ the breathing apparatus, to allow the shoulders room to fall back, and to support the head, without throwing it forward. the suffering of dying patients is immensely increased by neglect of these points. and many an invalid, too weak to drag about his pillows himself, slips his book or anything at hand behind the lower part of his back to support it. footnotes: [ ] [sidenote: nurses often do not think the sick room any business of theirs, but only, the sick.] i once told a "very good nurse" that the way in which her patient's room was kept was quite enough to account for his sleeplessness; and she answered quite good-humouredly she was not at all surprised at it--as if the state of the room were, like the state of the weather, entirely out of her power. now in what sense was this woman to be called a "nurse?" [ ] for the same reason if, after washing a patient, you must put the same night-dress on him again, always give it a preliminary warm at the fire. the night-gown he has worn must be, to a certain extent, damp. it has now got cold from having been off him for a few minutes. the fire will dry and at the same time air it. this is much more important than with clean things. ix. light. [sidenote: light essential to both health and recovery.] it is the unqualified result of all my experience with the sick, that second only to their need of fresh air is their need of light; that, after a close room, what hurts them most is a dark room. and that it is not only light but direct sun-light they want. i had rather have the power of carrying my patient about after the sun, according to the aspect of the rooms, if circumstances permit, than let him linger in a room when the sun is off. people think the effect is upon the spirits only. this is by no means the case. the sun is not only a painter but a sculptor. you admit that he does the photograph. without going into any scientific exposition we must admit that light has quite as real and tangible effects upon the human body. but this is not all. who has not observed the purifying effect of light, and especially of direct sunlight, upon the air of a room? here is an observation within everybody's experience. go into a room where the shutters are always shut (in a sick room or a bedroom there should never be shutters shut), and though the room be uninhabited, though the air has never been polluted by the breathing of human beings, you will observe a close, musty smell of corrupt air, of air _i.e._ unpurified by the effect of the sun's rays. the mustiness of dark rooms and corners, indeed, is proverbial. the cheerfulness of a room, the usefulness of light in treating disease is all-important. [sidenote: aspect, view, and sunlight matters of first importance to the sick.] a very high authority in hospital construction has said that people do not enough consider the difference between wards and dormitories in planning their buildings. but i go farther, and say, that healthy people never remember the difference between _bed_-rooms and _sick_-rooms in making arrangements for the sick. to a sleeper in health it does not signify what the view is from his bed. he ought never to be in it excepting when asleep, and at night. aspect does not very much signify either (provided the sun reach his bed-room some time in every day, to purify the air), because he ought never to be in his bed-room except during the hours when there is no sun. but the case is exactly reversed with the sick, even should they be as many hours out of their beds as you are in yours, which probably they are not. therefore, that they should be able, without raising themselves or turning in bed, to see out of window from their beds, to see sky and sun-light at least, if you can show them nothing else, i assert to be, if not of the very first importance for recovery, at least something very near it. and you should therefore look to the position of the beds of your sick one of the very first things. if they can see out of two windows instead of one, so much the better. again, the morning sun and the mid-day sun-- the hours when they are quite certain not to be up, are of more importance to them, if a choice must be made, than the afternoon sun. perhaps you can take them out of bed in the afternoon and set them by the window, where they can see the sun. but the best rule is, if possible, to give them direct sunlight from the moment he rises till the moment he sets. another great difference between the _bed_-room and the _sick_-room is, that the _sleeper_ has a very large balance of fresh air to begin with, when he begins the night, if his room has been open all day as it ought to be; the _sick_ man has not, because all day he has been breathing the air in the same room, and dirtying it by the emanations from himself. far more care is therefore necessary to keep up a constant change of air in the sick room. it is hardly necessary to add that there are acute cases (particularly a few ophthalmic cases, and diseases where the eye is morbidly sensitive), where a subdued light is necessary. but a dark north room is inadmissible even for these. you can always moderate the light by blinds and curtains. heavy, thick, dark window or bed curtains should, however, hardly ever be used for any kind of sick in this country. a light white curtain at the head of the bed is, in general, all that is necessary, and a green blind to the window, to be drawn down only when necessary. [sidenote: without sunlight, we degenerate body and mind.] one of the greatest observers of human things (not physiological), says, in another language, "where there is sun there is thought." all physiology goes to confirm this. where is the shady side of deep vallies, there is cretinism. where are cellars and the unsunned sides of narrow streets, there is the degeneracy and weakliness of the human race--mind and body equally degenerating. put the pale withering plant and human being into the sun, and, if not too far gone, each will recover health and spirit. [sidenote: almost all patients lie with their faces to the light.] it is a curious thing to observe how almost all patients lie with their faces turned to the light, exactly as plants always make their way towards the light; a patient will even complain that it gives him pain "lying on that side." "then why _do_ you lie on that side?" he does not know,--but we do. it is because it is the side towards the window. a fashionable physician has recently published in a government report that he always turns his patient's faces from the light. yes, but nature is stronger than fashionable physicians, and depend upon it she turns the faces back and _towards_ such light as she can get. walk through the wards of a hospital, remember the bed sides of private patients you have seen, and count how many sick you ever saw lying with their faces towards the wall. x. cleanliness of rooms and walls. [sidenote: cleanliness of carpets and furniture.] it cannot be necessary to tell a nurse that she should be clean, or that she should keep her patient clean,--seeing that the greater part of nursing consists in preserving cleanliness. no ventilation can freshen a room or ward where the most scrupulous cleanliness is not observed. unless the wind be blowing through the windows at the rate of twenty miles an hour, dusty carpets, dirty wainscots, musty curtains and furniture, will infallibly produce a close smell. i have lived in a large and expensively furnished london house, where the only constant inmate in two very lofty rooms, with opposite windows, was myself, and yet, owing to the above-mentioned dirty circumstances, no opening of windows could ever keep those rooms free from closeness; but the carpet and curtains having been turned out of the rooms altogether, they became instantly as fresh as could be wished. it is pure nonsense to say that in london a room cannot be kept clean. many of our hospitals show the exact reverse. [sidenote: dust never removed now.] but no particle of dust is ever or can ever be removed or really got rid of by the present system of dusting. dusting in these days means nothing but flapping the dust from one part of a room on to another with doors and windows closed. what you do it for i cannot think. you had much better leave the dust alone, if you are not going to take it away altogether. for from the time a room begins to be a room up to the time when it ceases to be one, no one atom of dust ever actually leaves its precincts. tidying a room means nothing now but removing a thing from one place, which it has kept clean for itself, on to another and a dirtier one.[ ] flapping by way of cleaning is only admissible in the case of pictures, or anything made of paper. the only way i know to _remove_ dust, the plague of all lovers of fresh air, is to wipe everything with a damp cloth. and all furniture ought to be so made as that it may be wiped with a damp cloth without injury to itself, and so polished as that it may be damped without injury to others. to dust, as it is now practised, truly means to distribute dust more equally over a room. [sidenote: floors.] as to floors, the only really clean floor i know is the berlin _lackered_ floor, which is wet rubbed and dry rubbed every morning to remove the dust. the french _parquet_ is always more or less dusty, although infinitely superior in point of cleanliness and healthiness to our absorbent floor. for a sick room, a carpet is perhaps the worst expedient which could by any possibility have been invented. if you must have a carpet, the only safety is to take it up two or three times a year, instead of once. a dirty carpet literally infects the room. and if you consider the enormous quantity of organic matter from the feet of people coming in, which must saturate it, this is by no means surprising. [sidenote: papered, plastered, oil-painted walls.] as for walls, the worst is the papered wall; the next worst is plaster. but the plaster can be redeemed by frequent lime-washing; the paper requires frequent renewing. a glazed paper gets rid of a good deal of the danger. but the ordinary bed-room paper is all that it ought _not_ to be.[ ] the close connection between ventilation and cleanliness is shown in this. an ordinary light paper will last clean much longer if there is an arnott's ventilator in the chimney than it otherwise would. the best wall now extant is oil paint. from this you can wash the animal exuviæ.[ ] these are what make a room musty. [sidenote: best kind of wall for a sick-room.] the best wall for a sick-room or ward that could be made is pure white non-absorbent cement or glass, or glazed tiles, if they were made sightly enough. air can be soiled just like water. if you blow into water you will soil it with the animal matter from your breath. so it is with air. air is always soiled in a room where walls and carpets are saturated with animal exhalations. want of cleanliness, then, in rooms _and_ wards, which you have to guard against, may arise in three ways. [sidenote: dirty air from without.] . dirty air coming in from without, soiled by sewer emanations, the evaporation from dirty streets, smoke, bits of unburnt fuel, bits of straw, bits of horse dung. [sidenote: best kind of wall for a house.] if people would but cover the outside walls of their houses with plain or encaustic tiles, what an incalculable improvement would there be in light, cleanliness, dryness, warmth, and consequently economy. the play of a fire-engine would then effectually wash the outside of a house. this kind of _walling_ would stand next to paving in improving the health of towns. [sidenote: dirty air from within.] . dirty air coming from within, from dust, which you often displace, but never remove. and this recalls what ought to be a _sine qua non_. have as few ledges in your room or ward as possible. and under no pretence have any ledge whatever out-of sight. dust accumulates there, and will never be wiped off. this is a certain way to soil the air. besides this, the animal exhalations from your inmates saturate your furniture. and if you never clean your furniture properly, how can your rooms or wards be anything but musty? ventilate as you please, the rooms will never be sweet. besides this, there is a constant _degradation_, as it is called, taking place from everything except polished or glazed articles--_e.g._ in colouring certain green papers arsenic is used. now in the very dust even, which is lying about in rooms hung with this kind of green paper, arsenic has been distinctly detected. you see your dust is anything but harmless; yet you will let such dust lie about your ledges for months, your rooms for ever. again, the fire fills the room with coal-dust. [sidenote: dirty air from the carpet.] . dirty air coming from the carpet. above all, take care of the carpets, that the animal dirt left there by the feet of visitors does not stay there. floors, unless the grain is filled up and polished, are just as bad. the smell from the floor of a school-room or ward, when any moisture brings out the organic matter by which it is saturated, might alone be enough to warn us of the mischief that is going on. [sidenote: remedies.] the outer air, then, can only be kept clean by sanitary improvements, and by consuming smoke. the expense in soap, which this single improvement would save, is quite incalculable. the inside air can only be kept clean by excessive care in the ways mentioned above--to rid the walls, carpets, furniture, ledges, &c., of the organic matter and dust--dust consisting greatly of this organic matter--with which they become saturated, and which is what really makes the room musty. without cleanliness, you cannot have all the effect of ventilation; without ventilation, you can have no thorough cleanliness. very few people, be they of what class they may, have any idea of the exquisite cleanliness required in the sick-room. for much of what i have said applies less to the hospital than to the private sick-room. the smoky chimney, the dusty furniture, the utensils emptied but once a day, often keep the air of the sick constantly dirty in the best private houses. the well have a curious habit of forgetting that what is to them but a trifling inconvenience, to be patiently "put up" with, is to the sick a source of suffering, delaying recovery, if not actually hastening death. the well are scarcely ever more than eight hours, at most, in the same room. some change they can always make, if only for a few minutes. even during the supposed eight hours, they can change their posture or their position in the room. but the sick man who never leaves his bed, who cannot change by any movement of his own his air, or his light, or his warmth; who cannot obtain quiet, or get out of the smoke, or the smell, or the dust; he is really poisoned or depressed by what is to you the merest trifle. "what can't be cured must be endured," is the very worst and most dangerous maxim for a nurse which ever was made. patience and resignation in her are but other words for carelessness or indifference --contemptible, if in regard to herself; culpable, if in regard to her sick. footnotes: [ ] [sidenote: how a room is _dusted_.] if you like to clean your furniture by laying out your clean clothes upon your dirty chairs or sofa, this is one way certainly of doing it. having witnessed the morning process called "tidying the room," for many years, and with ever-increasing astonishment, i can describe what it is. from the chairs, tables, or sofa, upon which the "things" have lain during the night, and which are therefore comparatively clean from dust or blacks, the poor "_things_" having "caught" it, they are removed to other chairs, tables, sofas, upon which you could write your name with your finger in the dust or blacks. the _other_ side of the "things" is therefore now evenly dirtied or dusted. the housemaid then flaps everything, or some things, not out of her reach, with a thing called a duster--the dust flies up, then re-settles more equally than it lay before the operation. the room has now been "put to rights." [ ] [sidenote: atmosphere in painted and papered rooms quite distinguishable.] i am sure that a person who has accustomed her senses to compare atmospheres proper and improper, for the sick and for children, could tell, blindfold, the difference of the air in old painted and in old papered rooms, _coeteris paribus._ the latter will always be dusty, even with all the windows open. [ ] [sidenote: how to keep your wall clean at the expense of your clothes.] if you like to wipe your dirty door, or some portion of your dirty wall, by hanging up your clean gown or shawl against it on a peg, this is one way certainly, and the most usual way, and generally the only way of cleaning either door or wall in a bed room! xi. personal cleanliness. [sidenote: poisoning by the skin.] in almost all diseases, the function of the skin is, more or less, disordered; and in many most important diseases nature relieves herself almost entirely by the skin. this is particularly the case with children. but the excretion, which comes from the skin, is left there, unless removed by washing or by the clothes. every nurse should keep this fact constantly in mind,--for, if she allow her sick to remain unwashed, or their clothing to remain on them after being saturated with perspiration or other excretion, she is interfering injuriously with the natural processes of health just as effectually as if she were to give the patient a dose of slow poison by the mouth. poisoning by the skin is no less certain than poisoning by the mouth--only it is slower in its operation. [sidenote: ventilation and skin-cleanliness equally essential.] the amount of relief and comfort experienced by sick after the skin has been carefully washed and dried, is one of the commonest observations made at a sick bed. but it must not be forgotten that the comfort and relief so obtained are not all. they are, in fact, nothing more than a sign that the vital powers have been relieved by removing something that was oppressing them. the nurse, therefore, must never put off attending to the personal cleanliness of her patient under the plea that all that is to be gained is a little relief, which can be quite as well given later. in all well-regulated hospitals this ought to be, and generally is, attended to. but it is very generally neglected with private sick. just as it is necessary to renew the air round a sick person frequently, to carry off morbid effluvia from the lungs and skin, by maintaining free ventilation, so is it necessary to keep the pores of the skin free from all obstructing excretions. the object, both of ventilation and of skin-cleanliness, is pretty much the same,--to wit, removing noxious matter from the system as rapidly as possible. care should be taken in all these operations of sponging, washing, and cleansing the skin, not to expose too great a surface at once, so as to check the perspiration, which would renew the evil in another form. the various ways of washing the sick need not here be specified,--the less so as the doctors ought to say which is to be used. in several forms of diarrhoea, dysentery, &c., where the skin is hard and harsh, the relief afforded by washing with a great deal of soft soap is incalculable. in other cases, sponging with tepid soap and water, then with tepid water and drying with a hot towel will be ordered. every nurse ought to be careful to wash her hands very frequently during the day. if her face too, so much the better. one word as to cleanliness merely as cleanliness. [sidenote: steaming and rubbing the skin.] compare the dirtiness of the water in which you have washed when it is cold without soap, cold with soap, hot with soap. you will find the first has hardly removed any dirt at all, the second a little more, the third a great deal more. but hold your hand over a cup of hot water for a minute or two, and then, by merely rubbing with the finger, you will bring off flakes of dirt or dirty skin. after a vapour bath you may peel your whole self clean in this way. what i mean is, that by simply washing or sponging with water you do not really clean your skin. take a rough towel, dip one corner in very hot water,--if a little spirit be added to it it will be more effectual,--and then rub as if you were rubbing the towel into your skin with your fingers. the black flakes which will come off will convince you that you were not clean before, however much soap and water you have used. these flakes are what require removing. and you can really keep yourself cleaner with a tumbler of hot water and a rough towel and rubbing, than with a whole apparatus of bath and soap and sponge, without rubbing. it is quite nonsense to say that anybody need be dirty. patients have been kept as clean by these means on a long voyage, when a basin full of water could not be afforded, and when they could not be moved out of their berths, as if all the appurtenances of home had been at hand. washing, however, with a large quantity of water has quite other effects than those of mere cleanliness. the skin absorbs the water and becomes softer and more perspirable. to wash with soap and soft water is, therefore, desirable from other points of view than that of cleanliness. xii. chattering hopes and advices. [sidenote: advising the sick.] the sick man to his advisers. "my advisers! their name is legion. * * * somehow or other, it seems a provision of the universal destinies, that every man, woman, and child should consider him, her, or itself privileged especially to advise me. why? that is precisely what i want to know." and this is what i have to say to them. i have been advised to go to every place extant in and out of england--to take every kind of exercise by every kind of cart, carriage---yes, and even swing (!) and dumb-bell (!) in existence; to imbibe every different kind of stimulus that ever has been invented; and this when those _best_ fitted to know, viz., medical men, after long and close attendance, had declared any journey out of the question, had prohibited any kind of motion whatever, had closely laid down the diet and drink. what would my advisers say, were they the medical attendants, and i the patient left their advice, and took the casual adviser's? but the singularity in legion's mind is this: it never occurs to him that everybody else is doing the same thing, and that i the patient _must_ perforce say, in sheer self-defence, like rosalind, "i could not do with all." [sidenote: chattering hopes the bane of the sick.] "chattering hopes" may seem an odd heading. but i really believe there is scarcely a greater worry which invalids have to endure than the incurable hopes of their friends. there is no one practice against which i can speak more strongly from actual personal experience, wide and long, of its effects during sickness observed both upon others and upon myself. i would appeal most seriously to all friends, visitors, and attendants of the sick to leave off this practice of attempting to "cheer" the sick by making light of their danger and by exaggerating their probabilities of recovery. far more now than formerly does the medical attendant tell the truth to the sick who are really desirous to hear it about their own state. how intense is the folly, then, to say the least of it, of the friend, be he even a medical man, who thinks that his opinion, given after a cursory observation, will weigh with the patient, against the opinion of the medical attendant, given, perhaps, after years of observation, after using every help to diagnosis afforded by the stethoscope, the examination of pulse, tongue, &c.; and certainly after much more observation than the friend can possibly have had. supposing the patient to be possessed of common sense,--how can the "favourable" opinion, if it is to be called an opinion at all, of the casual visitor "cheer" him,--when different from that of the experienced attendant? unquestionably the latter may, and often does, turn out to be wrong. but which is most likely to be wrong? [sidenote: patient does not want to talk of himself.] the fact is, that the patient[ ] is not "cheered" at all by these well-meaning, most tiresome friends. on the contrary, he is depressed and wearied. if, on the one hand, he exerts himself to tell each successive member of this too numerous conspiracy, whose name is legion, why he does not think as they do,--in what respect he is worse,--what symptoms exist that they know nothing of,--he is fatigued instead of "cheered," and his attention is fixed upon himself. in general, patients who are really ill, do not want to talk about themselves. hypochondriacs do, but again i say we are not on the subject of hypochondriacs. [sidenote: absurd consolations put forth for the benefit of the sick.] if, on the other hand, and which is much more frequently the case, the patient says nothing but the shakespearian "oh!" "ah!" "go to!" and "in good sooth!" in order to escape from the conversation about himself the sooner, he is depressed by want of sympathy. he feels isolated in the midst of friends. he feels what a convenience it would be, if there were any single person to whom he could speak simply and openly, without pulling the string upon himself of this shower-bath of silly hopes and encouragements; to whom he could express his wishes and directions without that person persisting in saying, "i hope that it will please god yet to give you twenty years," or, "you have a long life of activity before you." how often we see at the end of biographies or of cases recorded in medical papers, "after a long illness a. died rather suddenly," or, "unexpectedly both to himself and to others." "unexpectedly" to others, perhaps, who did not see, because they did not look; but by no means "unexpectedly to himself," as i feel entitled to believe, both from the internal evidence in such stories, and from watching similar cases; there was every reason to expect that a. would die, and he knew it; but he found it useless to insist upon his own knowledge to his friends. in these remarks i am alluding neither to acute cases which terminate rapidly nor to "nervous" cases. by the first much interest in, their own danger is very rarely felt. in writings of fiction, whether novels or biographies, these death-beds are generally depicted as almost seraphic in lucidity of intelligence. sadly large has been my experience in death-beds, and i can only say that i have seldom or never seen such. indifference, excepting with regard to bodily suffering, or to some duty the dying man desires to perform, is the far more usual state. the "nervous case," on the other hand, delights in figuring to himself and others a fictitious danger. but the long chronic case, who knows too well himself, and who has been told by his physician that he will never enter active life again, who feels that every month he has to give up something he could do the month before--oh! spare such sufferers your chattering hopes. you do not know how you worry and weary them. such real sufferers cannot bear to talk of themselves, still less to hope for what they cannot at all expect. so also as to all the advice showered so profusely upon such sick, to leave off some occupation, to try some other doctor, some other house, climate, pill, powder, or specific; i say nothing of the inconsistency-- for these advisers are sure to be the same persons who exhorted the sick man not to believe his own doctor's prognostics, because "doctors are always mistaken," but to believe some other doctor, because "this doctor is always right." sure also are these advisers to be the persons to bring the sick man fresh occupation, while exhorting him to leave his own. [sidenote: wonderful presumption of the advisers of the sick.] wonderful is the face with which friends, lay and medical, will come in and worry the patient with recommendations to do something or other, having just as little knowledge as to its being feasible, or even safe for him, as if they were to recommend a man to take exercise, not knowing he had broken his leg. what would the friend say, if _he_ were the medical attendant, and if the patient, because some _other_ friend had come in, because somebody, anybody, nobody, had recommended something, anything, nothing, were to disregard _his_ orders, and take that other body's recommendation? but people never think of this. [sidenote: advisers the same now as two hundred years ago.] a celebrated historical personage has related the commonplaces which, when on the eve of executing a remarkable resolution, were showered in nearly the same words by every one around successively for a period of six months. to these the personage states that it was found least trouble always to reply the same thing, viz., that it could not be supposed that such a resolution had been taken without sufficient previous consideration. to patients enduring every day for years from every friend or acquaintance, either by letter or _viva voce_, some torment of this kind, i would suggest the same answer. it would indeed be spared, if such friends and acquaintances would but consider for one moment, that it is probable the patient has heard such advice at least fifty times before, and that, had it been practicable, it would have been practised long ago. but of such consideration there appears to be no chance. strange, though true, that people should be just the same in these things as they were a few hundred years ago! to me these commonplaces, leaving their smear upon the cheerful, single-hearted, constant devotion to duty, which is so often seen in the decline of such sufferers, recall the slimy trail left by the snail on the sunny southern garden-wall loaded with fruit. [sidenote: mockery of the advice given to sick.] no mockery in the world is so hollow as the advice showered upon the sick. it is of no use for the sick to say anything, for what the adviser wants is, _not_ to know the truth about the state of the patient, but to turn whatever the sick may say to the support of his own argument, set forth, it must be repeated, without any inquiry whatever into the patient's real condition. "but it would be impertinent or indecent in me to make such an inquiry," says the adviser. true; and how much more impertinent is it to give your advice when you can know nothing about the truth, and admit you could not inquire into it. to nurses i say--these are the visitors who do your patient harm. when you hear him told:-- . that he has nothing the matter with him, and that he wants cheering. . that he is committing suicide, and that he wants preventing. . that he is the tool of somebody who makes use of him for a purpose. . that he will listen to nobody, but is obstinately bent upon his own way; and . that, he ought to be called to a sense of duty, and is flying in the face of providence;--then know that your patient is receiving all the injury that he can receive from a visitor. how little the real sufferings of illness are known or understood. how little does any one in good health fancy him or even _her_self into the life of a sick person. [sidenote: means of giving pleasure to the sick.] do, you who are about the sick or who visit the sick, try and give them pleasure, remember to tell them what will do so. how often in such visits the sick person has to do the whole conversation, exerting his own imagination and memory, while you would take the visitor, absorbed in his own anxieties, making no effort of memory or imagination, for the sick person. "oh! my dear, i have so much to think of, i really quite forgot to tell him that; besides, i thought he would know it," says the visitor to another friend. how could "he know it?" depend upon it, the people who say this are really those who have little "to think of." there are many burthened with business who always manage to keep a pigeon-hole in their minds, full of things to tell the "invalid." i do not say, don't tell him your anxieties--i believe it is good for him and good for you too; but if you tell him what is anxious, surely you can remember to tell him what is pleasant too. a sick person does so enjoy hearing good news:--for instance, of a love and courtship, while in progress to a good ending. if you tell him only when the marriage takes place, he loses half the pleasure, which god knows he has little enough of; and ten to one but you have told him of some love-making with a bad ending. a sick person also intensely enjoys hearing of any _material_ good, any positive or practical success of the right. he has so much of books and fiction, of principles, and precepts, and theories; do, instead of advising him with advice he has heard at least fifty times before, tell him of one benevolent act which has really succeeded practically,--it is like a day's health to him.[ ] you have no idea what the craving of sick with undiminished power of thinking, but little power of doing, is to hear of good practical action, when they can no longer partake in it. do observe these things with the sick. do remember how their life is to them disappointed and incomplete. you see them lying there with miserable disappointments, from which they can have no escape but death, and you can't remember to tell them of what would give them so much pleasure, or at least an hour's variety. they don't want you to be lachrymose and whining with them, they like you to be fresh and active and interested, but they cannot bear absence of mind, and they are so tired of the advice and preaching they receive from everybody, no matter whom it is, they see. there is no better society than babies and sick people for one another. of course you must manage this so that neither shall suffer from it, which is perfectly possible. if you think the "air of the sick room" bad for the baby, why it is bad for the invalid too, and, therefore, you will of course correct it for both. it freshens up a sick person's whole mental atmosphere to see "the baby." and a very young child, if unspoiled, will generally adapt itself wonderfully to the ways of a sick person, if the time they spend together is not too long. if you knew how unreasonably sick people suffer from reasonable causes of distress, you would take more pains about all these things. an infant laid upon the sick bed will do the sick person, thus suffering, more good than all your logic. a piece of good news will do the same. perhaps you are afraid of "disturbing" him. you say there is no comfort for his present cause of affliction. it is perfectly reasonable. the distinction is this, if he is obliged to act, do not "disturb" him with another subject of thought just yet; help him to do what he wants to do; but, if he _has_ done this, or if nothing _can_ be done, then "disturb" him by all means. you will relieve, more effectually, unreasonable suffering from reasonable causes by telling him "the news," showing him "the baby," or giving him something new to think of or to look at than by all the logic in the world. it has been very justly said that the sick are like children in this, that there is no _proportion_ in events to them. now it is your business as their visitor to restore this right proportion for them--to show them what the rest of the world is doing. how can they find it out otherwise? you will find them far more open to conviction than children in this. and you will find that their unreasonable intensity of suffering from unkindness, from want of sympathy, &c., will disappear with their freshened interest in the big world's events. but then you must be able to give them real interests, not gossip. [sidenote: two new classes of patients peculiar to this generation.] note.--there are two classes of patients which are unfortunately becoming more common every day, especially among women of the richer orders, to whom all these remarks are pre-eminently inapplicable. . those who make health an excuse for doing nothing, and at the same time allege that the being able to do nothing is their only grief. . those who have brought upon themselves ill-health by over pursuit of amusement, which they and their friends have most unhappily called intellectual activity. i scarcely know a greater injury that can be inflicted than the advice too often given to the first class to "vegetate"--or than the admiration too often bestowed on the latter class for "pluck." footnotes: [ ] [sidenote: absurd statistical comparisons made in common conversation by the most sensible people for the benefit of the sick.] there are, of course, cases, as in first confinements, when an assurance from the doctor or experienced nurse to the frightened suffering woman that there is nothing unusual in her case, that she has nothing to fear but a few hours' pain, may cheer her most effectually. this is advice of quite another order. it is the advice of experience to utter inexperience. but the advice we have been referring to is the advice of inexperience to bitter experience; and, in general, amounts to nothing more than this, that _you_ think _i_ shall recover from consumption because somebody knows somebody somewhere who has recovered from fever. i have heard a doctor condemned whose patient did not, alas! recover, because another doctor's patient of a _different_ sex, of a _different_ age, recovered from a _different_ disease, in a _different_ place. yes, this is really true. if people who make these comparisons did but know (only they do not care to know), the care and preciseness with which such comparisons require to be made, (and are made,) in order to be of any value whatever, they would spare their tongues. in comparing the deaths of one hospital with those of another, any statistics are justly considered absolutely valueless which do not give the ages, the sexes, and the diseases of all the cases. it does not seem necessary to mention this. it does not seem necessary to say that there can be no comparison between old men with dropsies and young women with consumptions. yet the cleverest men and the cleverest women are often heard making such comparisons, ignoring entirely sex, age, disease, place--in fact, _all_ the conditions essential to the question. it is the merest _gossip_. [ ] a small pet animal is often an excellent companion for the sick, for long chronic cases especially. a pet bird in a cage is sometimes the only pleasure of an invalid confined for years to the same room. if he can feed and clean the animal himself, he ought always to be encouraged to do so. xiii. observation of the sick. [sidenote: what is the use of the question, is he better?] there is no more silly or universal question scarcely asked than this, "is he better?" ask it of the medical attendant, if you please. but of whom else, if you wish for a real answer to your question, would you ask? certainly not of the casual visitor; certainly not of the nurse, while the nurse's observation is so little exercised as it is now. what you want are facts, not opinions--for who can have any opinion of any value as to whether the patient is better or worse, excepting the constant medical attendant, or the really observing nurse? the most important practical lesson that can be given to nurses is to teach them what to observe--how to observe--what symptoms indicate improvement--what the reverse--which are of importance--which are of none--which are the evidence of neglect--and of what kind of neglect. all this is what ought to make part, and an essential part, of the training of every nurse. at present how few there are, either professional or unprofessional, who really know at all whether any sick person they may be with is better or worse. the vagueness and looseness of the information one receives in answer to that much abused question, "is he better?" would be ludicrous, if it were not painful. the only sensible answer (in the present state of knowledge about sickness) would be "how can i know? i cannot tell how he was when i was not with him." i can record but a very few specimens of the answers[ ] which i have heard made by friends and nurses, and accepted by physicians and surgeons at the very bed-side of the patient, who could have contradicted every word, but did not--sometimes from amiability, often from shyness, oftenest from languor! "how often have the bowels acted, nurse?" "once, sir." this generally means that the utensil has been emptied once, it having been used perhaps seven or eight times. "do you think the patient is much weaker than he was six weeks ago?" "oh no, sir; you know it is very long since he has been up and dressed, and he can get across the room now." this means that the nurse has not observed that whereas six weeks ago he sat up and occupied himself in bed, he now lies still doing nothing; that, although he can "get across the room," he cannot stand for five seconds. another patient who is eating well, recovering steadily, although slowly, from fever, but cannot walk or stand, is represented to the doctor as making no progress at all. [sidenote: leading questions useless or misleading.] questions, too, as asked now (but too generally) of or about patients, would obtain no information at all about them, even if the person asked of had every information to give. the question is generally a leading question; and it is singular that people never think what must be the answer to this question before they ask it: for instance, "has he had a good night?" now, one patient will think he has a bad night if he has not slept ten hours without waking. another does not think he has a bad night if he has had intervals of dosing occasionally. the same answer has, actually been given as regarded two patients--one who had been entirely sleepless for five times twenty-four hours, and died of it, and another who had not slept the sleep of a regular night, without waking. why cannot the question be asked, how many hours' sleep has ---- had? and at what hours of the night?[ ] "i have never closed my eyes all night," an answer as frequently made when the speaker has had several hours' sleep as when he has had none, would then be less often said. lies, intentional and unintentional, are much seldomer told in answer to precise than to leading questions. another frequent error is to inquire whether one cause remains, and not whether the effect which may be produced by a great many different causes, _not_ inquired after, remains. as when it is asked, whether there was noise in the street last night; and if there were not, the patient is reported, without more ado, to have had a good night. patients are completely taken aback by these kinds of leading questions, and give only the exact amount of information asked for, even when they know it to be completely misleading. the shyness of patients is seldom allowed for. how few there are who, by five or six pointed questions, can elicit the whole case, and get accurately to know and to be able to report _where_ the patient is. [sidenote: means of obtaining inaccurate information.] i knew a very clever physician, of large dispensary and hospital practice, who invariably began his examination of each patient with "put your finger where you be bad." that man would never waste his time with collecting inaccurate information from nurse or patient. leading questions always collect inaccurate information. at a recent celebrated trial, the following leading question was put successively to nine distinguished medical men. "can you attribute these symptoms to anything else but poison?" and out of the nine, eight answered "no!" without any qualification whatever. it appeared, upon cross-examination:-- . that none of them had ever seen a case of the kind of poisoning supposed. . that none of them had ever seen a case of the kind of disease to which the death, if not to poison, was attributable. . that none of them were even aware of the main fact of the disease and condition to which the death was attributable. surely nothing stronger can be adduced to prove what use leading questions are of, and what they lead to. i had rather not say how many instances i have known, where, owing to this system of leading questions, the patient has died, and the attendants have been actually unaware of the principal feature of the case. [sidenote: as to food patient takes or does not take.] it is useless to go through all the particulars, besides sleep, in which people have a peculiar talent for gleaning inaccurate information. as to food, for instance, i often think that most common question, how is your appetite? can only be put because the questioner believes the questioned has really nothing the matter with him, which is very often the case. but where there is, the remark holds good which has been made about sleep. the _same_ answer will often be made as regards a patient who cannot take two ounces of solid food per diem, and a patient who does not enjoy five meals a day as much as usual. again, the question, how is your appetite? is often put when how is your digestion? is the question meant. no doubt the two things depend on one another. but they are quite different. many a patient can eat, if you can only "tempt his appetite." the fault lies in your not having got him the thing that he fancies. but many another patient does not care between grapes and turnips--everything is equally distasteful to him. he would try to eat anything which would do him good; but everything "makes him worse." the fault here generally lies in the cooking. it is not his "appetite" which requires "tempting," it is his digestion which requires sparing. and good sick cookery will save the digestion half its work. there may be four different causes, any one of which will produce the same result, viz., the patient slowly starving to death from want of nutrition: . defect in cooking; . defect in choice of diet; . defect in choice of hours for taking diet; . defect of appetite in patient. yet all these are generally comprehended in the one sweeping assertion that the patient has "no appetite." surely many lives might be saved by drawing a closer distinction; for the remedies are as diverse as the causes. the remedy for the first is to cook better; for the second, to choose other articles of diet; for the third, to watch for the hours when the patient is in want of food; for the fourth, to show him what he likes, and sometimes unexpectedly. but no one of these remedies will do for any other of the defects not corresponding with it. i cannot too often repeat that patients are generally either too languid to observe these things, or too shy to speak about them; nor is it well that they should be made to observe them, it fixes their attention upon themselves. again, i say, what _is_ the nurse or friend there for except to take note of these things, instead of the patient doing so?[ ] [sidenote: as to diarrhoea] again, the question is sometimes put, is there diarrhoea? and the answer will be the same, whether it is just merging into cholera, whether it is a trifling degree brought on by some trifling indiscretion, which will cease the moment the cause is removed, or whether there is no diarrhoea at all, but simply relaxed bowels. it is useless to multiply instances of this kind. as long as observation is so little cultivated as it is now, i do believe that it is better for the physician _not_ to see the friends of the patient at all. they will oftener mislead him than not. and as often by making the patient out worse as better than he really is. in the case of infants, _everything_ must depend upon the accurate observation of the nurse or mother who has to report. and how seldom is this condition of accuracy fulfilled. [sidenote: means of cultivating sound and ready observation.] a celebrated man, though celebrated only for foolish things, has told us that one of his main objects in the education of his son, was to give him a ready habit of accurate observation, a certainty of perception, and that for this purpose one of his means was a month's course as follows:--he took the boy rapidly past a toy-shop; the father and son then described to each other as many of the objects as they could, which they had seen in passing the windows, noting them down with pencil and paper, and returning afterwards to verify their own accuracy. the boy always succeeded best, e.g., if the father described objects, the boy did , and scarcely ever made a mistake. i have often thought how wise a piece of education this would be for much higher objects; and in our calling of nurses the thing itself is essential. for it may safely be said, not that the habit of ready and correct observation will by itself make us useful nurses, but that without it we shall be useless with all our devotion. i have known a nurse in charge of a set of wards, who not only carried in her head all the little varieties in the diets which each patient was allowed to fix for himself, but also exactly what each patient had taken during each day. i have known another nurse in charge of one single patient, who took away his meals day after day all but untouched, and never knew it. if you find it helps you to note down such things on a bit of paper, in pencil, by all means do so. i think it more often lames than strengthens the memory and observation. but if you cannot get the habit of observation one way or other, you had better give up the being a nurse, for it is not your calling, however kind and anxious you may be. surely you can learn at least to judge with the eye how much an oz. of solid food is, how much an oz. of liquid. you will find this helps your observation and memory very much, you will then say to yourself, "a. took about an oz. of his meat to day;" "b. took three times in hours about / pint of beef tea;" instead of saying "b. has taken nothing all day," or "i gave a. his dinner as usual." [sidenote: sound and ready observation essential in a nurse.] i have known several of our real old-fashioned hospital "sisters," who could, as accurately as a measuring glass, measure out all their patients' wine and medicine by the eye, and never be wrong. i do not recommend this, one must be very sure of one's self to do it. i only mention it, because if a nurse can by practice measure medicine by the eye, surely she is no nurse who cannot measure by the eye about how much food (in oz.) her patient has taken.[ ] in hospitals those who cut up the diets give with sufficient accuracy, to each patient, his oz. or his oz. of meat without weighing. yet a nurse will often have patients loathing all food and incapable of any will to get well, who just tumble over the contents of the plate or dip the spoon in the cup to deceive the nurse, and she will take it away without ever seeing that there is just the same quantity of food as when she brought it, and she will tell the doctor, too, that the patient has eaten all his diets as usual, when all she ought to have meant is that she has taken away his diets as usual. now what kind of a nurse is this? [sidenote: difference of excitable and _accumulative_ temperaments.] i would call attention to something else, in which nurses frequently fail in observation. there is a well-marked distinction between the excitable and what i will call the _accumulative_ temperament in patients. one will blaze up at once, under any shock or anxiety, and sleep very comfortably after it; another will seem quite calm and even torpid, under the same shock, and people say, "he hardly felt it at all," yet you will find him some time after slowly sinking. the same remark applies to the action of narcotics, of aperients, which, in the one, take effect directly, in the other not perhaps for twenty-four hours. a journey, a visit, an unwonted exertion, will affect the one immediately, but he recovers after it; the other bears it very well at the time, apparently, and dies or is prostrated for life by it. people often say how difficult the excitable temperament is to manage. i say how difficult is the _accumulative_ temperament. with the first you have an out-break which you could anticipate, and it is all over. with the second you never know where you are--you never know when the consequences are over. and it requires your closest observation to know what _are_ the consequences of what--for the consequent by no means follows immediately upon the antecedent--and coarse observation is utterly at fault. [sidenote: superstition the fruit of bad observation.] almost all superstitions are owing to bad observation, to the _post hoc, ergo propter hoc_; and bad observers are almost all superstitious. farmers used to attribute disease among cattle to witchcraft; weddings have been attributed to seeing one magpie, deaths to seeing three; and i have heard the most highly educated now-a-days draw consequences for the sick closely resembling these. [sidenote: physiognomy of disease little shewn by the face.] another remark: although there is unquestionably a physiognomy of disease as well as of health; of all parts of the body, the face is perhaps the one which tells the least to the common observer or the casual visitor. because, of all parts of the body, it is the one most exposed to other influences, besides health. and people never, or scarcely ever, observe enough to know how to distinguish between the effect of exposure, of robust health, of a tender skin, of a tendency to congestion, of suffusion, flushing, or many other things. again, the face is often the last to shew emaciation. i should say that the hand was a much surer test than the face, both as to flesh, colour, circulation, &c., &c. it is true that there are _some_ diseases which are only betrayed at all by something in the face, _e.g._, the eye or the tongue, as great irritability of brain by the appearance of the pupil of the eye. but we are talking of casual, not minute, observation. and few minute observers will hesitate to say that far more untruth than truth is conveyed by the oft repeated words, he _looks_ well, or ill, or better or worse. wonderful is the way in which people will go upon the slightest observation, or often upon no observation at all, or upon some _saw_ which the world's experience, if it had any, would have pronounced utterly false long ago. i have known patients dying of sheer pain, exhaustion, and want of sleep, from one of the most lingering and painful diseases known, preserve, till within a few days of death, not only the healthy colour of the cheek, but the mottled appearance of a robust child. and scores of times have i heard these unfortunate creatures assailed with, "i am glad to see you looking so well." "i see no reason why you should not live till ninety years of age." "why don't you take a little more exercise and amusement," with all the other commonplaces with which we are so familiar. there is, unquestionably, a physiognomy of disease. let the nurse learn it. the experienced nurse can always tell that a person has taken a narcotic the night before by the patchiness of the colour about the face, when the re-action of depression has set in; that very colour which the inexperienced will point to as a proof of health. there is, again, a faintness, which does not betray itself by the colour at all, or in which the patient becomes brown instead of white. there is a faintness of another kind which, it is true, can always be seen by the paleness. but the nurse seldom distinguishes. she will talk to the patient who is too faint to move, without the least scruple, unless he is pale and unless, luckily for him, the muscles of the throat are affected and he loses his voice. yet these two faintnesses are perfectly distinguishable, by the mere countenance of the patient. [sidenote: peculiarities of patients.] again, the nurse must distinguish between the idiosyncracies of patients. one likes to suffer out all his suffering alone, to be as little looked after as possible. another likes to be perpetually made much of and pitied, and to have some one always by him. both these peculiarities might be observed and indulged much more than they are. for quite as often does it happen that a busy attendance is forced upon the first patient, who wishes for nothing but to be "let alone," as that the second is left to think himself neglected. [sidenote: nurse must observe for herself increase of patient's weakness, patient will not tell her.] again, i think that few things press so heavily on one suffering from long and incurable illness, as the necessity of recording in words from time to time, for the information of the nurse, who will not otherwise see, that he cannot do this or that, which he could do a month or a year ago. what is a nurse there for if she cannot observe these things for herself? yet i have known--and known too among those--and _chiefly_ among those--whom money and position put in possession of everything which money and position could give--i have known, i say, more accidents (fatal, slowly or rapidly) arising from this want of observation among nurses than from almost anything else. because a patient could get out of a warm-bath alone a month ago--because a patient could walk as far as his bell a week ago, the nurse concludes that he can do so now. she has never observed the change; and the patient is lost from being left in a helpless state of exhaustion, till some one accidentally comes in. and this not from any unexpected apoplectic, paralytic, or fainting fit (though even these could be expected far more, at least, than they are now, if we did but _observe_). no, from the unexpected, or to be expected, inevitable, visible, calculable, uninterrupted increase of weakness, which none need fail to observe. [sidenote: accidents arising from the nurse's want of observation.] again, a patient not usually confined to bed, is compelled by an attack of diarrhoea, vomiting, or other accident, to keep his bed for a few days; he gets up for the first time, and the nurse lets him go into another room, without coming in, a few minutes afterwards, to look after him. it never occurs to her that he is quite certain to be faint, or cold, or to want something. she says, as her excuse, oh, he does not like to be fidgetted after. yes, he said so some weeks ago; but he never said he did not like to be "fidgetted after," when he is in the state he is in now; and if he did, you ought to make some excuse to go in to him. more patients have been lost in this way than is at all generally known, viz., from relapses brought on by being left for an hour or two faint, or cold, or hungry, after getting up for the first time. [sidenote: is the faculty of observing on the decline?] yet it appears that scarcely any improvement in the faculty of observing is being made. vast has been the increase of knowledge in pathology-- that science which teaches us the final change produced by disease on the human frame--scarce any in the art of observing the signs of the change while in progress. or, rather, is it not to be feared that observation, as an essential part of medicine, has been declining? which of us has not heard fifty times, from one or another, a nurse, or a friend of the sick, aye, and a medical friend too, the following remark:--"so a is worse, or b is dead. i saw him the day before; i thought him so much better; there certainly was no appearance from which one could have expected so sudden (?) a change." i have never heard any one say, though one would think it the more natural thing, "there _must_ have been _some_ appearance, which i should have seen if i had but looked; let me try and remember what there was, that i may observe another time." no, this is not what people say. they boldly assert that there was nothing to observe, not that their observation was at fault. let people who have to observe sickness and death look back and try to register in their observation the appearances which have preceded relapse, attack, or death, and not assert that there were none, or that there were not the _right_ ones.[ ] [sidenote: observation of general conditions.] a want of the habit of observing conditions and an inveterate habit of taking averages are each of them often equally misleading. men whose profession like that of medical men leads them to observe only, or chiefly, palpable and permanent organic changes are often just as wrong in their opinion of the result as those who do not observe at all. for instance, there is a broken leg; the surgeon has only to look at it once to know; it will not be different if he sees it in the morning to what it would have been had he seen it in the evening. and in whatever conditions the patient is, or is likely to be, there will still be the broken leg, until it is set. the same with many organic diseases. an experienced physician has but to feel the pulse once, and he knows that there is aneurism which will kill some time or other. but with the great majority of cases, there is nothing of the kind; and the power of forming any correct opinion as to the result must entirely depend upon an enquiry into all the conditions in which the patient lives. in a complicated state of society in large towns, death, as every one of great experience knows, is far less often produced by any one organic disease than by some illness, after many other diseases, producing just the sum of exhaustion necessary for death. there is nothing so absurd, nothing so misleading as the verdict one so often hears: so-and-so has no organic disease,--there is no reason why he should not live to extreme old age; sometimes the clause is added, sometimes not: provided he has quiet, good food, good air, &c., &c., &c.: the verdict is repeated by ignorant people _without_ the latter clause; or there is no possibility of the conditions of the latter clause being obtained; and this, the _only_ essential part of the whole, is made of no effect. i have heard a physician, deservedly eminent, assure the friends of a patient of his recovery. why? because he had now prescribed a course, every detail of which the patient had followed for years. and because he had forbidden a course which the patient could not by any possibility alter.[ ] undoubtedly a person of no scientific knowledge whatever but of observation and experience in these kinds of conditions, will be able to arrive at a much truer guess as to the probable duration of life of members of a family or inmates of a house, than the most scientific physician to whom the same persons are brought to have their pulse felt; no enquiry being made into their conditions. in life insurance and such like societies, were they instead of having the person examined by the medical man, to have the houses, conditions, ways of life, of these persons examined, at how much truer results would they arrive! w. smith appears a fine hale man, but it might be known that the next cholera epidemic he runs a bad chance. mr. and mrs. j. are a strong healthy couple, but it might be known that they live in such a house, in such a part of london, so near the river that they will kill four-fifths of their children; which of the children will be the ones to survive might also be known. [sidenote: "average rate of mortality" tells us only that so many per cent. will die. observation must tell us _which_ in the hundred they will be who will die.] averages again seduce us away from minute observation. "average mortalities" merely tell that so many per cent. die in this town and so many in that, per annum. but whether a or b will be among these, the "average rate" of course does not tell. we know, say, that from to per , will die in london next year. but minute enquiries into conditions enable us to know that in such a district, nay, in such a street,--or even on one side of that street, in such a particular house, or even on one floor of that particular house, will be the excess of mortality, that is, the person will die who ought not to have died before old age. now, would it not very materially alter the opinion of whoever were endeavouring to form one, if he knew that from that floor, of that house, of that street the man came. much more precise might be our observations even than this, and much more correct our conclusions. it is well known that the same names may be seen constantly recurring on workhouse books for generations. that is, the persons were born and brought up, and will be born and brought up, generation after generation, in the conditions which make paupers. death and disease are like the workhouse, they take from the same family, the same house, or in other words, the same conditions. why will we not observe what they are? the close observer may safely predict that such a family, whether its members marry or not, will become extinct; that such another will degenerate morally and physically. but who learns the lesson? on the contrary, it may be well known that the children die in such a house at the rate of out of ; one would think that nothing more need be said; for how could providence speak more distinctly? yet nobody listens, the family goes on living there till it dies out, and then some other family takes it. neither would they listen "if one rose from the dead." [sidenote: what observation is for.] in dwelling upon the vital importance of _sound_ observation, it must never be lost sight of what observation is for. it is not for the sake of piling up miscellaneous information or curious facts, but for the sake of saving life and increasing health and comfort. the caution may seem useless, but it is quite surprising how many men (some women do it too), practically behave as if the scientific end were the only one in view, or as if the sick body were but a reservoir for stowing medicines into, and the surgical disease only a curious case the sufferer has made for the attendant's special information. this is really no exaggeration. you think, if you suspected your patient was being poisoned, say, by a copper kettle, you would instantly, as you ought, cut off all possible connection between him and the suspected source of injury, without regard to the fact that a curious mine of observation is thereby lost. but it is not everybody who does so, and it has actually been made a question of medical ethics, what should the medical man do if he suspected poisoning? the answer seems a very simple one,--insist on a confidential nurse being placed with the patient, or give up the case. [sidenote: what a confidential nurse should be.] and remember every nurse should be one who is to be depended upon, in other words, capable of being, a "confidential" nurse. she does not know how soon she may find herself placed in such a situation; she must be no gossip, no vain talker; she should never answer questions about her sick except to those who have a right to ask them; she must, i need not say, be strictly sober and honest; but more than this, she must be a religious and devoted woman; she must have a respect for her own calling, because god's precious gift of life is often literally placed in her hands; she must be a sound, and close, and quick observer; and she must be a woman of delicate and decent feeling. [sidenote: observation is for practical purposes.] to return to the question of what observation is for:--it would really seem as if some had considered it as its own end, as if detection, not cure, was their business; nay more, in a recent celebrated trial, three medical men, according to their own account, suspected poison, prescribed for dysentery, and left the patient to the poisoner. this is an extreme case. but in a small way, the same manner of acting falls under the cognizance of us all. how often the attendants of a case have stated that they knew perfectly well that the patient could not get well in such an air, in such a room, or under such circumstances, yet have gone on dosing him with medicine, and making no effort to remove the poison from him, or him from the poison which they knew was killing him; nay, more, have sometimes not so much as mentioned their conviction in the right quarter--that is, to the only person who could act in the matter. footnotes: [ ] it is a much more difficult thing to speak the truth than people commonly imagine. there is the want of observation _simple_, and the want of observation _compound_, compounded, that is, with the imaginative faculty. both may equally intend to speak the truth. the information of the first is simply defective. that of the second is much more dangerous. the first gives, in answer to a question asked about a thing that has been before his eyes perhaps for years, information exceedingly imperfect, or says, he does not know. he has never observed. and people simply think him stupid. the second has observed just as little, but imagination immediately steps in, and he describes the whole thing from imagination merely, being perfectly convinced all the while that he has seen or heard it; or he will repeat a whole conversation, as if it were information which had been addressed to him; whereas it is merely what he has himself said to somebody else. this is the commonest of all. these people do not even observe that they have _not_ observed, nor remember that they have forgotten. courts of justice seem to think that anybody can speak "the whole truth, and nothing but the truth," if he does but intend it. it requires many faculties combined of observation and memory to speak "the whole truth," and to say "nothing but the truth." "i knows i fibs dreadful; but believe me, miss, i never finds out i have fibbed until they tells me so," was a remark actually made. it is also one of much more extended application than most people have the least idea of. concurrence of testimony, which is so often adduced as final proof, may prove nothing more, as is well known to those accustomed to deal with the unobservant imaginative, than that one person has told his story a great many times. i have heard thirteen persons "concur" in declaring that fourteenth, who had never left his bed, went to a distant chapel every morning at seven o'clock. i have heard persons in perfect good faith declare, that a man came to dine every day at the house where they lived, who had never dined there once; that a person had never taken the sacrament, by whose side they had twice at least knelt at communion; that but one meal a day came out of a hospital kitchen, which for six weeks they had seen provide from three to five and six meals a day. such instances might be multiplied _ad infinitum_ if necessary. [ ] this is important, because on this depends what the remedy will be. if a patient sleeps two or three hours early in the night, and then does not sleep again at all, ten to one it is not a narcotic he wants, but food or stimulus, or perhaps only warmth. if, on the other hand, he is restless and awake all night, and is drowsy in the morning, he probably wants sedatives, either quiet, coolness, or medicine, a lighter diet, or all four. now the doctor should be told this, or how can he judge what to give? [ ] [sidenote: more important to spare the patient thought than physical exertion.] it is commonly supposed that the nurse is there to spare the patient from making physical exertion for himself--i would rather say that she ought to be there to spare him from taking thought for himself. and i am quite sure, that if the patient were spared all thought for himself, and _not_ spared all physical exertion, he would be infinitely the gainer. the reverse is generally the case in the private house. in the hospital it is the relief from all anxiety, afforded by the rules of a well-regulated institution, which has often such a beneficial effect upon the patient. [ ] [sidenote: english women have great capacity of, but little practice in close observation.] it may be too broad an assertion, and it certainly sounds like a paradox. but i think that in no country are women to be found so deficient in ready and sound observation as in england, while peculiarly capable of being trained to it. the french or irish woman is too quick of perception to be so sound an observer--the teuton is too slow to be so ready an observer as the english woman might be. yet english women lay themselves open to the charge so often made against them by men, viz., that they are not to be trusted in handicrafts to which their strength is quite equal, for want of a practised and steady observation. in countries where women (with average intelligence certainly not superior to that of english women) are employed, e.g., in dispensing, men responsible for what these women do (not theorizing about man's and woman's "missions,") have stated that they preferred the service of women to that of men, as being more exact, more careful, and incurring fewer mistakes of inadvertence. now certainly english women are peculiarly capable of attaining to this. i remember when a child, hearing the story of an accident, related by some one who sent two girls to fetch a "bottle of salvolatile from her room;" "mary could not stir," she said, "fanny ran and fetched a bottle that was not salvolatile, and that was not in my room." now this sort of thing pursues every one through life. a woman is asked to fetch a large new bound red book, lying on the table by the window, and she fetches five small old boarded brown books lying on the shelf by the fire. and this, though she has "put that room to rights" every day for a month perhaps, and must have observed the books every day, lying in the same places, for a month, if she had any observation. habitual observation is the more necessary, when any sudden call arises. if "fanny" had observed "the bottle of salvolatile" in "the aunt's room," every day she was there, she would more probably have found it when it was suddenly wanted. there are two causes for these mistakes of inadvertence. . a want of ready attention; only a part of the request is heard at all. . a want of the habit of observation. to a nurse i would add, take care that you always put the same things in the same places; you don't know how suddenly you may be called on some day to find something, and may not be able to remember in your haste where you yourself had put it, if your memory is not in the habit of seeing the thing there always. [ ] [sidenote: approach of death, paleness by no means an invariable effect, as we find in novels.] it falls to few ever to have had the opportunity of observing the different aspects which the human face puts on at the sudden approach of certain forms of death by violence; and as it is a knowledge of little use, i only mention it here as being the most startling example of what i mean. in the nervous temperament the face becomes pale (this is the only _recognised_ effect); in the sanguine temperament purple; in the bilious yellow, or every manner of colour in patches. now, it is generally supposed that paleness is the one indication of almost any violent change in the human being, whether from terror, disease, or anything else. there can be no more false observation. granted, it is the one recognised livery, as i have said--_de rigueur_ in novels, but nowhere else. [ ] i have known two cases, the one of a man who intentionally and repeatedly displaced a dislocation, and was kept and petted by all the surgeons; the other of one who was pronounced to have nothing the matter with him, there being no organic change perceptible, but who died within the week. in both these cases, it was the nurse who, by accurately pointing out what she had accurately observed, to the doctors, saved the one case from persevering in a fraud, the other from being discharged when actually in a dying state. i will even go further and say, that in diseases which have their origin in the feeble or irregular action of some function, and not in organic change, it is quite an accident if the doctor who sees the case only once a day, and generally at the same time, can form any but a negative idea of its real condition. in the middle of the day, when such a patient has been refreshed by light and air, by his tea, his beef-tea, and his brandy, by hot bottles to his feet, by being washed and by clean linen, you can scarcely believe that he is the same person as lay with a rapid fluttering pulse, with puffed eye-lids, with short breath, cold limbs, and unsteady hands, this morning. now what is a nurse to do in such a case? not cry, "lord, bless you, sir, why you'd have thought he were a dying all night." this may be true, but it is not the way to impress with the truth a doctor, more capable of forming a judgment from the facts, if he did but know them, than you are. what he wants is not your opinion, however respectfully given, but your facts. in all diseases it is important, but in diseases which do not run a distinct and fixed course, it is not only important, it is essential that the facts the nurse alone can observe, should be accurately observed, and accurately reported to the doctor. i must direct the nurse's attention to the extreme variation there is not unfrequently in the pulse of such patients during the day. a very common case is this: between and a.m., the pulse become quick, perhaps , and so thready it is not like a pulse at all, but like a string vibrating just underneath the skin. after this the patient gets no more sleep. about mid-day the pulse has come down to ; and though feeble and compressible, is a very respectable pulse. at night, if the patient has had a day of excitement, it is almost imperceptible. but, if the patient has had a good day, it is stronger and steadier, and not quicker than at mid-day. this is a common history of a common pulse; and others, equally varying during the day, might be given. now, in inflammation, which may almost always be detected by the pulse, in typhoid fever, which is accompanied by the low pulse that nothing will raise, there is no such great variation. and doctors and nurses become accustomed not to look for it. the doctor indeed cannot. but the variation is in itself an important feature. cases like the above often "go off rather suddenly," as it is called, from some trifling ailment of a few days, which just makes up the sum of exhaustion necessary to produce death. and everybody cries, who would have thought it? except the observing nurse, if there is one, who had always expected the exhaustion to come, from which there would be no rally, because she knew the patient had no capital in strength on which to draw, if he failed for a few days to make his barely daily income in sleep and nutrition. i have often seen really good nurses distressed, because they could not impress the doctor with the real danger of their patient; and quite provoked because the patient "would look" either "so much better" or "so much worse" than he really is "when the doctor was there." the distress is very legitimate, but it generally arises from the nurse not having the power of laying clearly and shortly before the doctor the facts from which she derives her opinion, or from the doctor being hasty and inexperienced, and not capable of eliciting them. a man who really cares for his patients, will soon learn to ask for and appreciate the information of a nurse, who is at once a careful observer and a clear reporter. conclusion. [sidenote: sanitary nursing as essential in surgical as in medical cases, but not to supersede surgical nursing.] the whole of the preceding remarks apply even more to children and to puerperal woman than to patients in general. they also apply to the nursing of surgical, quite as much as to that of medical cases. indeed, if it be possible, cases of external injury require such care even more than sick. in surgical wards, one duty of every nurse certainly is _prevention_. fever, or hospital gangrene, or pyaemia, or purulent discharge of some kind may else supervene. has she a case of compound fracture, of amputation, or of erysipelas, it may depend very much on how she looks upon the things enumerated in these notes, whether one or other of these hospital diseases attacks her patient or not. if she allows her ward to become filled with the peculiar close foetid smell, so apt to be produced among surgical cases, especially where there is great suppuration and discharge, she may see a vigorous patient in the prime of life gradually sink and die where, according to all human probability, he ought to have recovered. the surgical nurse must be ever on the watch, ever on her guard, against want of cleanliness, foul air, want of light, and of warmth. nevertheless let no one think that because _sanitary_ nursing is the subject of these notes, therefore, what may be called the handicraft of nursing is to be undervalued. a patient may be left to bleed to death in a sanitary palace. another who cannot move himself may die of bed-sores, because the nurse does not know how to change and clean him, while he has every requisite of air, light, and quiet. but nursing, as a handicraft, has not been treated of here for three reasons: . that these notes do not pretend to be a manual for nursing, any more than for cooking for the sick; . that the writer, who has herself seen more of what may be called surgical nursing, i.e. practical manual nursing, than, perhaps, any one in europe, honestly believes that it is impossible to learn it from any book, and that it can only be thoroughly learnt in the wards of a hospital; and she also honestly believes that the perfection of surgical nursing may be seen practised by the old-fashioned "sister" of a london hospital, as it can be seen nowhere else in europe. . while thousands die of foul air, &c., who have this surgical nursing to perfection, the converse is comparatively rare. [sidenote: children: their greater susceptibility to the same things.] to revert to children. they are much more susceptible than grown people to all noxious influences. they are affected by the same things, but much more quickly and seriously, viz., by want of fresh air, of proper warmth, want of cleanliness in house, clothes, bedding, or body, by startling noises, improper food, or want of punctuality, by dulness and by want of light, by too much or too little covering in bed, or when up, by want of the spirit of management generally in those in charge of them. one can, therefore, only press the importance, as being yet greater in the case of children, greatest in the case of sick children, of attending to these things. that which, however, above all, is known to injure children seriously is foul air, and most seriously at night. keeping the rooms where they sleep tight shut up, is destruction to them. and, if the child's breathing be disordered by disease, a few hours only of such foul air may endanger its life, even where no inconvenience is felt by grown-up persons in the same room. the following passages, taken out of an excellent "lecture on sudden death in infancy and childhood," just published, show the vital importance of careful nursing of children. "in the great majority of instances, when death suddenly befalls the infant or young child, it is an _accident_; it is not a necessary result of any disease from which it is suffering." it may be here added, that it would be very desirable to know how often death is, with adults, "not a necessary, inevitable result of any disease." omit the word "sudden;" (for _sudden_ death is comparatively rare in middle age;) and the sentence is almost equally true for all ages. the following causes of "accidental" death in sick children are enumerated:--"sudden noises, which startle--a rapid change of temperature, which chills the surface, though only for a moment--a rude awakening from sleep--or even an over-hasty, or an overfull meal"--"any sudden impression on the nervous system--any hasty alteration of posture--in short, any cause whatever by which the respiratory process may be disturbed." it may again be added, that, with very weak adult patients, these causes are also (not often "suddenly fatal," it is true, but) very much oftener than is at all generally known, irreparable in their consequences. both for children and for adults, both for sick and for well (although more certainly in the case of sick children than in any others), i would here again repeat, the most frequent and most fatal cause of all is sleeping, for even a few hours, much more for weeks and months, in foul air, a condition which, more than any other condition, disturbs the respiratory process, and tends to produce "accidental" death in disease. i need hardly here repeat the warning against any confusion of ideas between cold and fresh air. you may chill a patient fatally without giving him fresh air at all. and you can quite well, nay, much better, give him fresh air without chilling him. this is the test of a good nurse. in cases of long recurring faintnesses from disease, for instance, especially disease which affects the organs of breathing, fresh air to the lungs, warmth to the surface, and often (as soon as the patient can swallow) hot drink, these are the right remedies and the only ones. yet, oftener than not, you see the nurse or mother just reversing this; shutting up every cranny through which fresh air can enter, and leaving the body cold, or perhaps throwing a greater weight of clothes upon it, when already it is generating too little heat. "breathing carefully, anxiously, as though respiration were a function which required all the attention for its performance," is cited as a not unusual state in children, and as one calling for care in all the things enumerated above. that breathing becomes an almost voluntary act, even in grown up patients who are very weak, must often have been remarked. "disease having interfered with the perfect accomplishment of the respiratory function, some sudden demand for its complete exercise, issues in the sudden standstill of the whole machinery," is given as one process:--"life goes out for want of nervous power to keep the vital functions in activity," is given as another, by which "accidental" death is most often brought to pass in infancy. also in middle age, both these processes may be seen ending in death, although generally not suddenly. and i have seen, even in middle age, the "_sudden_ stand-still" here mentioned, and from the same causes. [sidenote: summary.] to sum up:--the answer to two of the commonest objections urged, one by women themselves, the other by men, against the desirableness of sanitary knowledge for women, _plus_ a caution, comprises the whole argument for the art of nursing. [sidenote: reckless amateur physicking by women. real knowledge of the laws of health alone can check this.] ( .) it is often said by men, that it is unwise to teach women anything about these laws of health, because they will take to physicking,--that there is a great deal too much of amateur physicking as it is, which is indeed true. one eminent physician told me that he had known more calomel given, both at a pinch and for a continuance, by mothers, governesses, and nurses, to children than he had ever heard of a physician prescribing in all his experience. another says, that women's only idea in medicine is calomel and aperients. this is undeniably too often the case. there is nothing ever seen in any professional practice like the reckless physicking by amateur females.[ ] but this is just what the really experienced and observing nurse does _not_ do; she neither physics herself nor others. and to cultivate in things pertaining to health observation and experience in women who are mothers, governesses or nurses, is just the way to do away with amateur physicking, and if the doctors did but know it, to make the nurses obedient to them,--helps to them instead of hindrances. such education in women would indeed diminish the doctor's work--but no one really believes that doctors wish that there should be more illness, in order to have more work. [sidenote: what pathology teaches. what observation alone teaches. what medicine does. what nature alone does.] ( .) it is often said by women, that they cannot know anything of the laws of health, or what to do to preserve their children's health, because they can know nothing of "pathology," or cannot "dissect,"--a confusion of ideas which it is hard to attempt to disentangle. pathology teaches the harm that disease has done. but it teaches nothing more. we know nothing of the principle of health, the positive of which pathology is the negative, except from observation and experience. and nothing but observation and experience will teach us the ways to maintain or to bring back the state of health. it is often thought that medicine is the curative process. it is no such thing; medicine is the surgery of functions, as surgery proper is that of limbs and organs. neither can do anything but remove obstructions; neither can cure; nature alone cures. surgery removes the bullet out of the limb, which is an obstruction to cure, but nature heals the wound. so it is with medicine; the function of an organ becomes obstructed; medicine, so far as we know, assists nature to remove the obstruction, but does nothing more. and what nursing has to do in either case, is to put the patient in the best condition for nature to act upon him. generally, just the contrary is done. you think fresh air, and quiet and cleanliness extravagant, perhaps dangerous, luxuries, which should be given to the patient only when quite convenient, and medicine the _sine qua non_, the panacea. if i have succeeded in any measure in dispelling this illusion, and in showing what true nursing is, and what it is not, my object will have been answered. now for the caution:-- ( .) it seems a commonly received idea among men and even among women themselves that it requires nothing but a disappointment in love, the want of an object, a general disgust, or incapacity for other things, to turn a woman into a good nurse. this reminds one of the parish where a stupid old man was set to be schoolmaster because he was "past keeping the pigs." apply the above receipt for making a good nurse to making a good servant. and the receipt will be found to fail. yet popular novelists of recent days have invented ladies disappointed in love or fresh out of the drawing-room turning into the war-hospitals to find their wounded lovers, and when found, forthwith abandoning their sick-ward for their lover, as might be expected. yet in the estimation of the authors, these ladies were none the worse for that, but on the contrary were heroines of nursing. what cruel mistakes are sometimes made by benevolent men and women in matters of business about which they can know nothing and think they know a great deal. the everyday management of a large ward, let alone of a hospital--the knowing what are the laws of life and death for men, and what the laws of health for wards--(and wards are healthy or unhealthy, mainly according to the knowledge or ignorance of the nurse)--are not these matters of sufficient importance and difficulty to require learning by experience and careful inquiry, just as much as any other art? they do not come by inspiration to the lady disappointed in love, nor to the poor workhouse drudge hard up for a livelihood. and terrible is the injury which has followed to the sick from such wild notions! in this respect (and why is it so?), in roman catholic countries, both writers and workers are, in theory at least, far before ours. they would never think of such a beginning for a good working superior or sister of charity. and many a superior has refused to admit a _postulant_ who appeared to have no better "vocation" or reasons for offering herself than these. it is true _we_ make "no vows." but is a "vow" necessary to convince us that the true spirit for learning any art, most especially an art of charity, aright, is not a disgust to everything or something else? do we really place the love of our kind (and of nursing, as one branch of it) so low as this? what would the mère angélique of port royal, what would our own mrs. fry have said to this? note.--i would earnestly ask my sisters to keep clear of both the jargons now current every where (for they _are_ equally jargons); of the jargon, namely, about the "rights" of women, which urges women to do all that men do, including the medical and other professions, merely because men do it, and without regard to whether this _is_ the best that women, can do; and of the jargon which urges women to do nothing that men do, merely because they are women, and should be "recalled to a sense of their duty as women," and because "this is women's work," and "that is men's," and "these are things which women should not do," which is all assertion, and nothing more. surely woman should bring the best she has, _whatever_ that is, to the work of god's world, without attending to either of these cries. for what are they, both of them, the one _just_ as much as the other, but listening to the "what people will say," to opinion, to the "voices from without?" and as a wise man has said, no one has ever done anything great or useful by listening to the voices from without. you do not want the effect of your good things to be, "how wonderful for a _woman_!" nor would you be deterred from good things by hearing it said, "yes, but she ought not to have done this, because it is not suitable for a woman." but you want to do the thing that is good, whether it is "suitable for a woman" or not. it does not make a thing good, that it is remarkable that a woman should have been able to do it. neither does it make a thing bad, which would have been good had a man done it, that it has been done by a woman. oh, leave these jargons, and go your way straight to god's work, in simplicity and singleness of heart. footnotes: [ ] [sidenote: danger of physicking by amateur females.] i have known many ladies who, having once obtained a "blue pill" prescription from a physician, gave and took it as a common aperient two or three times a week--with what effect may be supposed. in one case i happened to be the person to inform the physician of it, who substituted for the prescription a comparatively harmless aperient pill. the lady came to me and complained that it "did not suit her half so well." if women will take or give physic, by far the safest plan is to send for "the doctor" every time--for i have known ladies who both gave and took physic, who would not take the pains to learn the names of the commonest medicines, and confounded, _e.g._, colocynth with colchicum. this _is_ playing with sharp-edged tools "with a vengeance." there are excellent women who will write to london to their physician that there is much sickness in their neighbourhood in the country, and ask for some prescription from him, which they used to like themselves, and then give it to all their friends and to all their poorer neighbours who will take it. now, instead of giving medicine, of which you cannot possibly know the exact and proper application, nor all its consequences, would it not be better if you were to persuade and help your poorer neighbours to remove the dung-hill from before the door, to put in a window which opens, or an arnott's ventilator, or to cleanse and lime-wash the cottages? of these things the benefits are sure. the benefits of the inexperienced administration of medicines are by no means so sure. homoeopathy has introduced one essential amelioration in the practice of physic by amateur females; for its rules are excellent, its physicking comparatively harmless--the "globule" is the one grain of folly which appears to be necessary to make any good thing acceptable. let then women, if they will give medicine, give homoeopathic medicine. it won't do any harm. an almost universal error among women is the supposition that everybody _must_ have the bowels opened once in every twenty-four hours, or must fly immediately to aperients. the reverse is the conclusion of experience. this is a doctor's subject, and i will not enter more into it; but will simply repeat, do not go on taking or giving to your children your abominable "courses of aperients," without calling in the doctor. it is very seldom indeed, that by choosing your diet, you cannot regulate your own bowels; and every woman may watch herself to know what kind of diet will do this; i have known deficiency of meat produce constipation, quite as often as deficiency of vegetables; baker's bread much oftener than either. home made brown bread will oftener cure it than anything else. appendix. [transcriber's note: these tables have been transposed to fit the page width. the figures in the left hand column, table b: nurse (not domestic servant) do not add up. there is probably a typographical error in this column since it cannot be accounted for by errors in transcription.] table a. great britain. ages. nurses. nurse (not domestic nurse (domestic servant) servant) all ages. , , under years ... ... - ... - ... , - ... , - , - , - , , - , , - , , - , , - , , - , - , - , - , - - and upwards table b. aged years, and upwards. nurses. nurse (not domestic nurse (domestic servant) servant) great britain and , , islands in the british seas. england and wales. , , scotland. , , islands in the british seas. st division. london. , , nd division. south eastern. , , rd division. south midland. , , th division. eastern counties. , th division. south western counties. , , th division. west midland counties. , , th division. north midland counties. , th division. north western counties. , th division. yorkshire. , , th division. northern counties. th division. monmouth and wales. note as to the number of women employed as nurses in great britain. , were returned, at the census of , as nurses by profession, , nurses in domestic service,[ ] and , midwives. the numbers of different ages are shown in table a, and in table b their distribution over great britain. to increase the efficiency of this class, and to make as many of them as possible the disciples of the true doctrines of health, would be a great national work. for there the material exists, and will be used for nursing, whether the real "conclusion of the matter" be to nurse or to poison the sick. a man, who stands perhaps at the head of our medical profession, once said to me, i send a nurse into a private family to nurse the sick, but i know that it is only to do them harm. now a nurse means any person in charge of the personal health of another. and, in the preceding notes, the term _nurse_ is used indiscriminately for amateur and professional nurses. for, besides nurses of the sick and nurses of children, the numbers of whom are here given, there are friends or relations who take temporary charge of a sick person, there are mothers of families. it appears as if these unprofessional nurses were just as much in want of knowledge of the laws of health as professional ones. then there are the schoolmistresses of all national and other schools throughout the kingdom. how many of children's epidemics originate in these! then the proportion of girls in these schools, who become mothers or members among the , nurses recorded above, or schoolmistresses in their turn. if the laws of health, as far as regards fresh air, cleanliness, light, &c., were taught to these, would this not prevent some children being killed, some evil being perpetuated? on women we must depend, first and last, for personal and household hygiene--for preventing the race from degenerating in as far as these things are concerned. would not the true way of infusing the art of preserving its own health into the human race be to teach the female part of it in schools and hospitals, both by practical teaching and by simple experiments, in as far as these illustrate what may be called the theory of it? [ ] a curious fact will be shown by table a, viz., that , out of , , or nearly one-half of all the nurses, in domestic service, are between and years of age. note: project gutenberg also has an html version of this file which includes the original illustration. see -h.htm or -h.zip: (http://www.gutenberg.org/files/ / -h/ -h.htm) or (http://www.gutenberg.org/files/ / -h.zip) the red cross girls with pershing to victory [illustration: nona] the red cross girls with pershing to victory by margaret vandercook author of "the ranch girls series," "stories about camp fire girls series," etc. illustrated the john c. winston company philadelphia copyright, , by the john c. winston co. contents chapter page i. with the american army in france ii. a late recruit iii. toward germany iv. luxemburg v. shoals vi. the ride vii. an unexpected situation viii. the countess's story ix. "life's little ironies" x. the talk with sonya xi. the journey to coblenz xii. new year's eve in coblenz xiii. a walk along the river bank xiv. major james hersey xv. a re-entrance xvi. a growing friendship xvii. faith and unfaith xviii. reconciliation xix. a warning xx. nora jamison explains xxi. the rainbow bridge the red cross girls with pershing to victory chapter i _with the american army in france_ it was a bright winter day near the middle of november, the ground hard with frost and light flurries of snow in the air. over the sloping french countryside thousands of brown tents arose like innumerable, giant anthills, while curling above certain portions of the camp were long columns of smoke. american soldiers were walking about in a leisurely fashion, or standing in groups talking. some of them were engaged in cleaning their guns or other military accoutrements, a number were investigating their kits. near one of the camp fires a private was singing to the accompaniment of a guitar and a banjo played by two other soldiers, with a fairly large crowd surrounding them. "johnny get your gun, we've the hun on the run." over the entire american camp there was an atmosphere of relaxation, of cheerfulness, of duty accomplished. the eleventh of november having passed, with the armistice signed, the american soldiers in france were now awaiting orders either to return home to the united states or else to march toward the rhine. in this particular neighborhood of château-thierry no word had yet been received as to what units were to form a part of the american army of occupation, only the information that the units were to be chosen with regard to their military accomplishments since their arrival in france. therefore the heroes of château-thierry and of belleau woods, of st. mihiel and the argonne forest were ready to accept whatever fate sent, "home," or "the watch on the rhine." finally ending his song the singer stood up; he was wearing the uniform of the united states marines. "i say don't stop singing, navara. what's a fellow to do these days without your music, when we have no longer the noise of the cannon or the shrieking of guns overhead as a substitute?" one of the group of soldiers exclaimed. "the quiet has come so suddenly it is almost as hard to grow accustomed to it, as it once was to the infernal racket." "oh, navara is expecting visitors, feminine visitors. some people have all the luck!" corporal donald hackett protested, placing his banjo in its case and also rising. he spoke with a slight southern drawl and was a tall, fair young fellow with brilliant blue eyes, and both his hair and skin burned red by exposure to the outdoors. "come along then and be introduced to my friends; a good many of you fellows know them already," carlo navara answered. "mrs. david clark and six red cross nurses are motoring over from the red cross hospital. i suppose you have been told that sometime this afternoon half a dozen of our men are to be cited. an officer is coming from headquarters to represent the commander in chief, and present the medals. in a short time we must be ready for inspection." moving off together the two men formed an interesting contrast. carlo navara was dark, a little below medium height, with closely cut brown hair, rather extraordinary black eyes and an olive skin. the young singer, an american of italian ancestry, had first fought among the snow-clad hills of italy. wounded, he had afterwards returned to the united states, where a great career as a singer was opening before him. then the desire to fight in france had driven him to surrender his art and to serve as a volunteer in the marine corps. a moment later the two men disappeared within their tents. an automobile with the red cross insignia soon after drove up before one of the entrances to the camp where a sentry stood guard. stepping out of it first came a woman, youthful of face and form, but whose hair was nearly white, her eyes a deep blue with dark lashes, and her color a bright crimson from her drive through the winter air. following her immediately was a young girl, scarcely eighteen years old, who was small and fair with pale blonde hair and surprisingly dark brown eyes. both the woman and girl were wearing heavy fur coats and small hats fitting close down over their hair. the older woman was mrs. david clark, the wife of the chief surgeon of the red cross hospital which was situated a few miles from the present camp. before her marriage which had taken place only a little more than six months before, she had been sonya valesky. the young girl was her ward, bianca zoli. "i declare, sonya, i don't see how you always manage to get ahead of the rest of us considering your advanced years," another girl exclaimed, jumping out of the car and slipping on the icy ground until her older friend caught firm hold of her. "do be careful, nona davis, and don't be humorous until you are more sure of your footing," sonya clark replied. "you know when you return to new york i want captain martin to find you as well as when you said goodby to him. but have you dr. clark's note to the officer of the day? i'll ask the sentry to take it in to him." during the few moments mrs. clark and nona davis were talking, four other red cross nurses had followed their example and were out of the automobile. they were now walking up and down on the frozen road for warmth and exercise. they were mildred thornton and her sister-in-law, barbara thornton, who had been doing red cross nursing in nearly every one of the allied countries since the outbreak of the great war. the other two girls had been nursing in france only for the past year. one of them, ruth carroll, was taller than any of her companions and strongly built, with dusky hair and grey eyes set wide apart. her companion was tiny, with bright red hair, rather nondescript features and a few freckles, in spite of the season of the year, upon her upturned nose. yet theodosia thompson, with her full red lips, her small, even white teeth and her dancing light blue eyes under a fringe of reddish brown lashes, was by no means plain. "aren't you praying every moment, ruth, that we may be ordered forward with the army of occupation into germany? personally i shall not be happy until i see with my own eyes the germans actually tasting the bitterness of defeat. i made a vow to myself that i would not go back home until general pershing had led our troops to victory, and a real victory means the stars and stripes floating over a portion of the german country." the older and larger of the two american girls smiled a slow, gentle smile characteristic of her personality and in sharp contrast with her companion's impetuous speech and action. both girls were kentuckians and had been friends for years before sailing to do red cross work in france. "well, i have never been so fierce a character as you, thea! to me victory will seem assured the day peace is signed. yet if any of the divisions of soldiers among whom we have been nursing are ordered to germany, certainly i hope our red cross unit may accompany them. i presume not nearly so many nurses will be needed as in the fighting days, however." in the interval, while this conversation was taking place, mrs. clark's note had been dispatched to the officer of the day. at this moment major hersey appeared. major james hersey, confidentially known among his battalion as "jimmie" had the distinction of being one of the youngest majors in the united states army, and to his own regret was not only less than twenty-five years old but looked even younger. "i am so awfully glad to see you, mrs. clark," he began, blushing furiously without apparent reason, as he spoke, which was an uncomfortable habit. "i want you to congratulate me. we have just had a telephone message from headquarters saying that we are to form a part of the first big unit of the american army occupational force. we are to begin to move toward germany at half past five o'clock sunday morning, and i am tremendously pleased. our orders are to march two days and rest three and our troops will move on a front of fifty miles for two weeks when we expect to reach the rhine. but forgive my enthusiasm, mrs. clark. you are the first person to whom i have told the good news. even the men don't know yet. you'll say hurrah with me." major hersey ended boyishly, forgetting military etiquette in his enthusiasm. he had a round, youthful face, curly light brown hair and eyes of nearly the same shade. later, when sonya had offered her congratulations, insisting, however, that she was not surprised by the news if military accomplishment had been considered, she and major hersey led the way into the american camp in the neighborhood of château-thierry followed by the six american girls. half an hour afterwards the same information had been disseminated throughout the camp. lieutenant-colonel townsend had also arrived to award the citations and the distinguished service crosses to the officers and soldiers who had merited the distinction. never were sonya clark and the six red cross nurses to forget this, their last picture of an american camp in france before the great movement of the victorious army toward the rhine. the clouds of the earlier afternoon had grown heavier and more snow was falling in larger flakes, so that the earth was covered with a thin white carpet. a cold wind was blowing across the winter fields. the american soldiers stood in long, even lines, erect, rugged and efficient. sonya and her group of red cross nurses managed to protect themselves a little from the cold by standing behind a group of officers and near one of the officer's tents, not far from lieutenant-colonel townsend and major hersey. they were the only women in the camp at the present time. therefore the only feminine applause emanated from them when the first young officer came forward to receive his citation from the hands of the commanding officer. first lieutenant leon de funiak was a young french officer who had been attached to a division of the united states marines. in the name of the president he was presented with the distinguished service cross for extraordinary heroism in action near st. mihiel on september when with excellent courage he had captured a machine gun which he turned upon an adjoining trench forcing the enemy occupants to surrender. the second award was made to corporal donald hackett, a friend of carlo navara's and an acquaintance of the red cross girls. later, two citations were given to privates with whom they had no acquaintance. the afternoon sun was disappearing and the wind growing colder. bianca zoli, who stood between her guardian and nona davis, shivered. unconscious of what she was doing she also gave a little sigh due to fatigue and cold. younger than her companions she was also more fragile in appearance. her guardian now turned toward her. "i am sorry, bianca, you are worn out. i am afraid you should not have come with us. yet it is impossible to leave now until the citations are over." at this same moment, another name was being announced by the commanding officer. instantly bianca zoli's manner and appearance changed. her cheeks became a warm crimson, her dark eyes glowed, her lips even trembled slightly although she held the lower one firm with her small white teeth. the name called was private carlo navara. the distinguished service cross was his award. early in the previous july he had crossed as a spy into the enemy's lines and there secured information which had proved of extraordinary value to the commander in chief of the allied armies. half an hour later, returning to the red cross hospital, which lay a few miles behind the american camp, bianca zoli sat wrapped in a rug for further warmth, yet her expression had continued radiant. with her pale fair hair blowing from underneath her fur cap, her eyes deep and dark and happy underneath a little fringe of snow which had fallen and clung to her long lashes, she looked oddly pretty. "do you think, sonya, that carlo knew he was to be cited this afternoon?" she demanded. "he has always said that his own share in the expedition into the german lines last summer was a failure and that the success was entirely due lieutenant wainwright, mildred thornton's fiancé. has carlo spoken to you on the subject recently? had he been told he was to be decorated?" a little absently the older woman nodded, at the present moment she was thinking of other matters even more absorbing than carlo navara's recent honor, proud as she felt of her friend. earlier in the day her husband, dr. david clark, the surgeon in charge of the red cross hospital, had confided in her that a unit of his nurses and physicians were to follow the american army to the frontiers of germany. dr. clark had also asked his wife's advice with regard to the nurses who had best accompany them. therefore, all the afternoon, with her subconscious mind sonya had been endeavoring to meet and unravel this personal problem, at the same time she shared in the interest of the military ceremony to which she had been a witness. "yes, i believe carlo did know what he might expect bianca," she answered finally. "at least he told me a day or so ago he had received some word that there was to be some public recognition of his deed. i suppose carlo did not like to discuss the matter generally as he is a more modest soldier than he is an artist." the younger girl flushed. "just the same i should think carlo might also have confided in me. i wonder if he will ever realize that you are not the best friend he has in the world, even if he does continue to think so." the older woman smiled without replying. sonya knew that some day bianca would recover from her childish jealous relation between herself and carlo navara. of late carlo, himself, had grown entirely sensible, appreciating the fact that her marriage had ended forever his mistaken romantic attachment for a woman so much older than himself, to whose kindness in caring for him during his illness in italy he believed he owed so much. moreover, sonya's attention was soon engaged in watching the storm. during the past two hours the snow fall had been growing heavier until now it lay thick along the road and was blown into drifts by the roadside. the wind was swirling in fierce gusts and forming whirlwinds of snow in unexpected places. save for the lights in their motor car the way was nearly dark, as daylight had almost completely disappeared. cautiously, although driving his car at a fairly rapid pace, the chauffeur was speeding toward the hospital. then suddenly without warning he stopped his car so abruptly that its occupants were thrown forward out of their seats. "what is it, what has happened?" sonya clark asked, as soon as she had recovered sufficient breath, then opening the door of the closed car she peered out into the snow-covered road. a little beyond she was able to see an object lying in the road only a few feet beyond their car. in the semi-darkness and at the distance, with the snow forming a thick veil between, it was impossible to tell just what the object might be. partly covered with snow and showing no sign of movement it was probably an animal that had gone astray and been frozen in the november storm. quickly sonya got out of the car followed by mildred thornton and ruth carroll, the other girls remaining in the automobile at her request. the chauffeur joined them. the next moment the four of them were bending over the figure of a young girl, who was wearing a close fitting cap and a long dark blue coat, and sewed on her sleeve a small red cross. yet when sonya spoke to her, she showed no sign of being able to reply and made no movement, not even to the raising of her lashes. when the chauffeur lifted and placed her inside the car she still seemed unconscious. "i think we had best go on to the hospital at once," sonya commanded. "we are not more than a few moments' journey and whatever should be done for this girl can be better accomplished there." chapter ii _a late recruit_ a little before noon the following day, mrs. david clark, the wife of the surgeon in command of the red cross hospital near château-thierry, entered a small room in one of the towers of the old french château, which had been serving as a hospital for the american wounded. the room was in the portion of the building set apart for the use of the red cross nurses. opening the door quietly and without knocking, sonya stood for a moment in silence upon the threshold, staring in polite amazement at the figure she beheld sitting upright in the small hospital bed. the figure was that of a young girl with straight brown hair cut short and parted at one side, a rather thin white face with a pointed chin and large hazel eyes. there was a boyish, or perhaps more of a sprite-like quality in her appearance. as sonya looked straightway she saw a fleeting picture of peter pan, before the girl turned and spoke to her. "you are mrs. clark aren't you? you are very kind to come to ask about me. i am sorry i gave you so much trouble yesterday; another mile or more and i should have arrived safely at the hospital and been none the worse for my long walk. you won't mind if i go on eating a moment longer, will you? i am dreadfully hungry and i have just succeeded in persuading the charming little girl who is taking care of me that there is nothing in the world the matter with me today, except the need for food. i really feel no worse from yesterday's experience, although it is nice to be so deliciously warm after one has come fairly near being frozen." as the girl talked, the older woman came and took a little chair beside the bed. the newcomer to the hospital, who had been rescued from the snow storm the afternoon before, sonya now discovered was not so young as she had originally believed. on closer observation there were tiny lines about the girl's eyes, a little droop at the corners of her mouth, which might, however, be due partly to fatigue and exposure. "when you feel inclined and if you are strong enough, i wonder if you will not tell me something about yourself and where you were trying to go when we picked you up yesterday? red cross nurses have been in many unexpected places since the beginning of the war, yet one scarcely looks to find one lost in the snow in such a picturesque fashion," sonya suggested half smiling and half serious. in answer to sonya's speech, the girl pushed the tray of food which by this time she had finished eating, to the bottom of her bed and sat resting her chin in the palms of her hands. she was leaning forward with her shoulders lifted and wearing a little white flannel dressing sacque which bianca zoli must have loaned to her. "i want very much to explain to you, mrs. clark, and i am entirely all right again, only perhaps a little tired from my adventure. i do not seem even to have taken cold. first of all my name is nora jamison and i have traveled all the way from california to france, across a country and across an ocean. was it my good fortune or my ill fortune that i landed in paris just three days before the armistice was signed to begin my red cross nursing? i have been looking forward to the opportunity it seems to me for years. oh, i have done war nursing, but near one of the california camps." the girl turned her eyes at this moment to glance out the small window cut into the wall just beside her bed. they were remarkable eyes, sonya had already observed, sometimes a light brown in shade, then flecked with green and grey tones. not in any sense was the rest of the face beautiful, although oddly interesting, the nose long and delicate, the lips thin with slightly irregular white teeth. "i want to see what this french country is like, mrs. clark, see it until i shall never forget its desolation as compared to the fruitfulness and tranquility of our own. some day when i return home i mean to make some of my own country people share my impression with me." then without further explanation of her meaning she turned again to her companion. "i wonder if you are going to be willing to do me a great favor? strange, i know, to be asking a favor of some one who has never seen one and knows nothing of one, save that i am already in your debt! i want you to take me with you as one of your red cross nurses to work with the army of occupation on the rhine. please don't refuse me yet. "when i arrived in paris three days before the signing of the armistice i was kept waiting there until the day after the celebration. then i was told that if i preferred i could stay on in paris a week or more and go back home, since now that the war was over, there would be less need for red cross nurses. yet somehow i managed to plead my cause and the morning after the armistice i was ordered to report to dr. clark at his hospital near château-thierry. probably there would be nurses who were tired and would now wish to be discharged and sent home. i was told that a letter had been written dr. clark to expect me. there was a very especial reason why i wished to come to this neighborhood which i would like to tell you later. well, i had a fairly difficult journey from paris. i was alone and know almost no french. but there was no one to send with me and even the red cross organization relaxed just a little with the prospect of peace. nevertheless nothing happened to me of any importance until i reached the station where i was told some one would be waiting to drive me to the hospital. there was no one. but the mistake was mine, because i thought an old frenchman told me the red cross hospital was only five miles away. at present, knowing my own failure to understand french i think that he probably said fifteen miles. however, i feel i must have walked nearer fifty, if i may exaggerate the actual facts. i kept asking in my best french to be told the proper direction and thinking i understood and then getting lost. when i started out from the little french station it was early in the morning and really not very cold; you must not think i am altogether without judgment. but now that i am safely here, you will take me with you to germany? just think how far i have traveled for this chance! your other nurses have had their opportunity." two bright spots of color were at this moment glowing on the girl's cheeks, her lips and eyes were eager as a child. nevertheless sonya shook her head. "i am sorry, miss jamison, but i'm afraid i can't promise anything. in the first place, my husband has already made the choice of the red cross nurses who are to form his unit. he selected his staff of nurses and physicians last night. there is no time for delay. the division of troops we are to serve leaves before dawn sunday morning. the red cross units will bring up the rear. we will probably move later on the same morning. don't think i am not sympathetic; why you must feel like the last of our american troops who reached château-thierry the morning of the armistice. major hersey told me it was difficult to keep them from fighting, armistice, or no armistice. but you will be able to remain here at the hospital for a time. we still have a number of the wounded to be cared for and more than half the staff will stay behind." the new nurse covered her eyes for a moment with her hands, they were beautiful nurse's hands, with long slender, firm fingers. "mrs. clark, i haven't any immediate family, the one person i cared for and to whom i was engaged was killed here in the neighborhood of château-thierry at one of the first engagements of the united states troops. we had planned to do wonderful things with our life together after the war was past and he was safely home. now, i haven't the courage, not for a time anyhow, to go on with what we hoped to do. i must have work, change, movement. i am very strong, see how quickly i have recovered from yesterday. to stay here at the hospital and work now that the war is over would of course be better than going home at once. but the hospital will be sure to close in a little time and the men sent nearer the coast so as to be ready to sail as soon as they are able. may i at least talk to dr. clark? will you ask him to give me a few moments? i shall be dressed in a little while and can come to his office." sonya rose up from her chair and stood hesitating a moment. there was something in the girl's story, something in her face which was oddly wistful and appealing. more than an ordinary loss lay behind her quickly told tragedy. "why, yes, i'll speak to dr. clark if you desire it and in any case he will wish to know you have recovered. yet i am afraid i cannot truthfully hold out much hope to you. as a matter of fact i have not personally the least influence with my husband in professional matters. if i had, well i should like to take you with our red cross unit to the rhine," and sonya stooped, obeying an unusual impulse and kissed the new girl lightly on the forehead before leaving her. chapter iii _toward germany_ "happy is he who takes the open road, from rosy sunburst till the stars ascend. light is his heart, though heavy be his load, if love but waits him at his journey's end." the two red cross nurses, theodosia thompson and ruth carroll were standing together at the edge of a bleak field in the dawn of a mid-november morning. their companion was a young american physician. "what an extraordinary quotation under the present circumstances, thea! but then, since you are a bundle of contradictions, i presume you suggest that love will await us at our journey's end when you really mean hate. i wonder to what extent the germans will hate us and how difficult life will be among them when we occupy their cities on the rhine." ruth carroll, who had begun her speech as an answer to the other girl, now concluded it by turning her gaze upon dr. hugh raymond, who made no effort at the moment to answer so unanswerable a question. "oh, i was not thinking of the entrance of our american troops into germany, but into belgium and the little devastated french villages which have not seen a friendly face in over four years," theodosia thompson replied. "our soldiers must first pass through the rescued towns. but actually, ruth, i was not thinking deeply at all. with the knowledge that we were soon to take the open road, the verse came into my mind. please don't always be so matter of fact." possibly the two girls were talking because it is so difficult for girls to remain silent for any length of time even under the most amazing conditions. at this moment, peering steadfastly through the grey light of the approaching day, with dr. raymond beside them, they were beholding one of the greatest spectacles in human history, the first movement of the american army of occupation toward the rhine. in line with the vision of the three watchers at this instant khaki-clad figures were marching slowly forward with their faces turned toward the east. behind them down the long road ammunition and supply trains were lumbering; cannons and big guns were groaning their way onward as in time of war. but although it was not war, but the vanguard of peace, nevertheless the american soldiers were prepared for war, should the armistice be ended at any moment. overhead observation balloons were floating, which were to move more rapidly than the army and form a part of the advance guard. "we are scheduled to enter virton some time tomorrow, miss thompson. virton is the first town across the belgian border, then briey and longwy and then the little duchy of luxemburg. it is a great trek and i am glad to be allowed to join it. yet somehow i wish we were sending our nurses in dirigibles so as to make the journey more quickly and safely. we have suffered so much from german treachery in the past that i can't quite trust them on this march. yet personally i wish i could have gone with the soldiers." the young american doctor spoke slowly and solemnly. he was a tall slender fellow with sandy hair and a rather finely cut face, a little roman in type. his manner was also slightly dictatorial, as if he were a much older and wiser person than his feminine audience, although he was scarcely twenty-five. theodosia thompson paid no attention to his remarks although he seemed to be addressing her; however ruth carroll listened as interestedly as any one could have desired. dr. raymond had not been as friendly with the red cross nurses at the château-thierry hospital as one might naturally have expected, considering the fact that they had worked and dreamed and prayed under the same roof during the last thrilling months before the close of the war. but he was supposed not to care for women or girls, either because he was too shy, or because he suffered from an undue sense of superiority. notwithstanding, he apparently made a mild exception in favor of ruth carroll, although for her intimate friend and companion, thea thompson, ordinarily he had to make an effort to conceal his dislike. over the french country this morning the snow of a few days before had hardened and been beaten down into a frost covered layer of mud, yet the wind had become a little quieter and not so piercingly cold. "don't you think we had best go back to the hospital in a few moments, thea?" ruth at this instant inquired. "there are still preparations for us to make before our red cross unit takes its place in the line of march. as a matter of fact i don't think i slept three hours last night, and neither dr. clark nor mrs. clark made a pretence of going to bed." thea linked her arm in ruth's. the young physician who was their companion wore a curious, rapt expression. he was still gazing after the moving army, and seemed not to have heard. "goodby, dr. raymond." thea made a little curtsey that was unexpectedly graceful. "thank you for suggesting to ruth that she see the first breaking of camp of the american army of occupation. i know you had not intended that i accompany you, yet thank you just the same. never so long as i live shall i forget this daybreak in france! why, it is as if an old world had ended on the eleventh of november and a new one was beginning today! besides who knows what experiences may lie ahead, or _romances_, dr. raymond. you see now the war has ended, perhaps even you may wake up to other interesting facts in life beside professional ones." with an odd, challenging expression, thea thompson watched the young doctor's face, expecting him at least to change color or show some sign of annoyance. however, as he was a good deal taller than she, he merely looked over her head and toward ruth carroll. "if you will forgive me, miss carroll, i won't return with you just this minute. i have nothing very special to look after and i want to see as much of this first movement of our army as possible. afterwards our red cross motors and ambulances will probably have to keep in the rear." then the two girls moved away toward the red cross hospital choosing their route along a path near the edge of the road, so as not to be in the way of the oncoming trucks. "i do wish you would try not to talk personalities on a morning like this, thea dear," ruth urged gently, "and particularly not to dr. raymond. i have told you it makes him uncomfortable. he is really not aware that there is a woman or a girl in the world in any personal fashion. i am sure the very word _romance_ irritates him. i presume that is why you used it. don't get into mischief now that the war is over, thea, because you may have less hard work when you have been so good all the past year. i feel it specially because i know you did not naturally care for nursing and only began it at first in order to come to france with me. still you have been very successful and perhaps may wish to keep on with nursing as a profession after we return home?" a little sound that was neither assent nor refusal followed. then thea thompson shook her head. "let's don't discuss either the past or the future just now, ruth. thank heaven the present is sufficient! i've an idea that once our soldiers reach the rhine and settle down they will be needing entertainment as much as they will need nursing. personally i intend to have a little relief from this long strain and have as good a time as possible. oh, don't look so shocked, ruth. i don't intend to do anything especially wicked, play a little perhaps and be a little frivolous. you and i are certainly contrasts as kentucky girls! you know there may be a chance we may run across a little princess somewhere in hiding and that she may fall in love with one of our american soldiers. american soldiers are greater than kings these days, and princesses are in need of protection. so perhaps i may be a looker-on at some one else's romance and not have one of my own. i have been a looker-on at many things i have wished for myself before today, ruth, as you know. but please let us hurry. i promised mrs. clark we would not stay away from the hospital but a short time and i wish to keep my word. she does not like me particularly, or at least i seem to puzzle her." ruth carroll shook her head. the girl beside her had not had a happy childhood or young girlhood, so perhaps it was natural that she should wish, as she expressed it, "just to have a good time." "you puzzle a good many people, thea, including me and sometimes you even puzzle yourself. but you know i have always believed the good would win in the end. don't spoil your nursing record. we are very fortunate to have been chosen to form a part of the red cross unit to follow the army." at this moment the grey november clouds parted and a pale rose appeared in the sky. the two girls were reaching the neighborhood of their red cross hospital. drawn up nearby were half a dozen red cross ambulances, an equal number of closed cars and several large trucks for carrying medical supplies. moving about and directing the hospital orderlies was dr. david clark, the surgeon in command of the hospital. he had been ordered to take charge of the red cross unit, who were to follow the division of american troops from the neighborhood of château-thierry to the rhine to assist in policing germany. with him at the moment, and aiding in a hundred small ways, was his wife, sonya clark. as the two nurses approached and dr. clark caught sight of them, he frowned with disapproval and surprise. at the instant it seemed impossible to guess what two of his nurses could be doing off duty at daybreak on this morning of all mornings. sonya understood and nodded sympathetically. "you have been to see our troops break camp and start for germany? i remember you asked permission. i envy you girls the experience, although we shall probably see many extraordinary sights before this day is over. we shall leave in a few hours; naturally it will not take long for us in motor cars, to catch up with the soldiers who are traveling afoot. you will be ready. i hope the sky at present is a good omen of the future." and sonya pointed to the rose light overhead. later in the day, the red cross unit from the hospital in the neighborhood of château-thierry took its place in the rear of the line of march of the american army of occupation toward germany. by this time the sun was shining and the roads had become comparatively clear. hospital supplies had been sent on ahead with a group of hospital orderlies, dr. clark and a corps of his physicians following soon after. in a later automobile mrs. clark had with her half a dozen red cross nurses, and in a second miss blackstone, the former superintendent of the hospital, an equal number. also there was a third automobile filled with physicians and orderlies who were to keep as close to the two other cars as circumstances allowed. across no man's land on this november morning, from the northern end of france to the southern, were passing the victorious allied armies, three hundred thousand american troops led by pershing to victory, and an equal or greater number of french and british. in the car with sonya the american girls had but little to say to one another during the first part of their journey. not only was the land before them desolate beyond description, but filled with tragic memories. early in the afternoon, reaching the edge of a little french town, the red cross automobiles stopped. the occupants were in no great hurry to move forward. in advance the cavalry had swept on to prepare the way, but the infantry was going ahead slowly and would encamp for the night. this division of the red cross intended keeping in the background so that in case the men became ill, they could drop out and be overtaken by nurses and physicians. the girls were glad of the rest and also extraordinarily hungry, having spent the greater part of the night and every moment since daylight in preparation for the advance. their three cars had stopped in front of a small farmhouse on the outskirts of the town. approaching the house, sonya and dr. raymond believed it to be empty. the blinds were closed, the pathway to the front door untrodden. yet it had once been a gay little house of french grey with bright blue shutters. a knock at the door and both sonya and the young physician thought they heard scurrying noises inside. yet knocking again there was no reply. "shall i try pushing the little front door open, mrs. clark? it is pretty cold eating outside. i can't quite understand the situation. the french people know we are their friends; they have been told to expect nothing but kindness and consideration from us. do look, already the french civilians are coming out from the village to welcome us. our little house is surely uninhabited or it would not be so inhospitable." following dr. raymond's suggestion, sonya turned. standing not far away in a group were the six red cross nurses for whom she felt especially responsible, nona davis and mildred thornton, the two girls who were her intimate and devoted friends and who had made exceptional sacrifices to remain in europe now that the war was ended. there were also the two comparatively new nurses, ruth carroll and theodosia thompson, and bianca zoli. the sixth girl was the red cross nurse, nora jamison, who had arrived so late at the hospital. nevertheless she had been chosen by dr. clark to form a member of his red cross unit who were to follow the army of occupation. beyond them was another group of nurses and physicians. to sonya's surprise she saw approaching at this moment from the little french town close by between fifty and a hundred persons. some of them were old men and women hobbling along on sticks, their faces gaunt and haggard with past suffering, but shining now with happiness. a dozen or more little french girls were marching abreast, one of them carrying a small american flag, another a french. both flags were evidently home made and must have been carefully hidden from the germans during their long occupancy of the french village. with them were five or six american soldiers who had been taken prisoners by the germans and were now being allowed to rejoin their own comrades. "we haven't a great deal of food, i know," sonya began impulsively. "but don't you think, dr. raymond, we might ask the friends who have come to welcome us and who seem hungriest to share our food? a great quantity of supplies are to follow us and we will probably wait for a few days somewhere along the line of march. dr. clark told me he wanted us to be prepared to care for the wounded american soldiers we meet along the way, soldiers who have been imprisoned in germany and must have suffered untold tortures from improper treatment. then, if any of our own soldiers are taken ill along the route of march, dr. clark is to see they are left in a comfortable hospital with the necessary supplies and it may be we shall be delayed to look after them." forgetting her effort to enter the little house, sonya at this instant moved away from dr. raymond to rejoin the other red cross nurses. in french fashion some of the old peasants were kissing the hands of their allies. miss blackstone and a physician had already unwound a dirty bandage from the arm of an american soldier and were examining his wound. sonya had no desire to be left out of the little crowd of french and american friends. within fifteen minutes, however, she had again returned to the little house. this time she was accompanied by an old french peasant woman to whom she had explained the situation, inquiring if the farmhouse was in truth uninhabited. at present it was the french woman who hammered, not gently but with the utmost firmness upon the closed door. "it may not be possible, madame, that we enter in at the front door," she explained. "it is my impression that la petite louisa has never once unfastened this door since she opened it to the german soldiers who afterwards took away her mother and older sister. she has been here ever since all alone, as her father and brother were of course with the army. la petite louisa has since that time been distrait, not you understand exactly in her right senses, but harmless. it is not that her french neighbors have neglected her. i have myself tried to take her home to be with me, but always she comes back to the little grey house." the old peasant shrugged her shoulders, as she continued banging on the door and talking at the same time. "there have been so many things to endure. one more forsaken, half starved child! what would you do? her family was not well known in our village; they had moved here from paris a short time before the war and were said to have been wealthy people who had fallen into misfortune. so after a time, it may not seem kind, but life has been too hard some of the days even for kindness, so finally we left the little girl alone. neighbors have given her food when there was food to give. even a few of the enemy soldiers have sometimes tried to make friends and persuade her to eat, but always she would rush away from them with the great fear." not altogether sure of what the old french peasant was trying to make plain to her, yet convinced enough of the tragedy of the story, sonya laid her hand on the old woman's arm. "don't you think we had best not frighten the little girl then by trying to enter her house. some one else in the village i feel sure will offer us hospitality. and yet something should be done for the little girl, now the war is past she must be made to understand she need not be afraid," sonya expostulated. however, the french woman continued knocking. she also had been calling out in french, reassuring the little girl inside, pleading with her. "la petite louisa." and now sonya heard footsteps drawing near the closed door. the next moment the door partly opened, disclosing the most pathetic child's figure she had ever seen. the little girl was perhaps twelve years old and did not look like the usual french child, for though her hair was coal black, her eyes were a violet blue, fringed by the blackest lashes, her skin almost an unearthly pallor. in spite of her look of hunger she was clean and not only scrupulously, but exquisitely dressed in a little silk and serge frock made with care and taste. the child's eyes were what held sonya, however, they were at once so terrified and so sad. looking past the two women at the crowd outside, she would have fallen except that sonya's arm went swiftly around her while she tried to explain that they were friends. afterwards sonya and the red cross nurses discovered that the little house was furnished very differently from the ordinary french farmhouse, with possessions which must have come from some handsomer home. in the dining room they ate their luncheon on a french oak table with beautiful carved feet and found that the sideboard and chairs were also of handsome french oak. the little room soon became crowded, not only with the red cross girls and physicians, but with a number of the french people who came in to assist in the celebration. beyond gifts of chocolate and bread, they refused to accept other food, explaining that the portion of the american army which had passed through their village earlier in the day had given them supplies. yet the little french girl in whose home the celebration was taking place would neither eat nor speak to her french acquaintances or to the strange americans. sonya and miss blackstone confided to each other their impression that the little girl was probably unable to speak, fright and exhaustion having oftentimes this effect upon highly nervous temperaments. however, in the midst of the luncheon, suddenly the little french girl slipped over beside the new red cross nurse, nora jamison, and took tight hold of her hand. she even allowed her to tempt her into eating small morsels of food. by accident the new nurse was sitting next sonya clark and sonya turned to her, mystified by the little french girl's impetuous action. "i wonder how you managed that, miss jamison?" she inquired. "i have been trying to make friends with our little french hostess ever since my meeting with her and she would have nothing to do with me. you seem not to have noticed her and she has given her confidence to you." still holding the little french girl's hand nora jamison nodded. "you will find i am a kind of pied piper, mrs. clark. i had always nursed children before i began war work and am especially fond of them." sonya shook her head. "it is peter pan i thought of when i first saw you. i wonder if you are one of the lucky persons who never grow up? i've an idea you will be a great help to us when we finally reach germany. we don't want the german children to think of us as ogres and one wonders what stories their parents may now be telling them of our american soldiers." then so many things distracted sonya clark's attention that she thought no more of the little deserted french girl until she and bianca looked for her to say goodby and found that the child had disappeared. chapter iv _luxemburg_ in the afternoon, traveling in the direction of belgium, there was an unexpected movement under the broad seat of the red cross car which startled its occupants. the first exclamation came from bianca zoli who happened to be sitting just over a space where a large box of provisions originally had been stored. the box had been removed, however, and the food eaten at luncheon. "i am absurd!" bianca exclaimed, clutching at nora jamison's hand, as she was sitting beside her. "but i thought i felt something stir. i wonder if the excitement of our journey is having a strange influence upon me?" "i don't think so," the older girl returned, "i have been conscious of life, a movement of some kind underneath us ever since we left the little french farmhouse. i say i have been conscious, no, i have not been exactly that, only puzzled and uncomfortable." leaning over, nora at this instant lifted the curtain, and bianca bending forward at the same time, they both became aware of the figure of the little french girl who had vanished a few moments before their departure from her home. "sonya!" bianca called. this was scarcely necessary, since by this time every occupant of the car knew equally well what had happened and curiously enough, without discussion, understood the explanation for the child's action. the little girl had believed that this group of women and girls, wearing the red cross of service, were her friends and if possible would protect her from what she feared most in all the world, the grey uniformed german soldiers. also they were leaving the neighborhood where she had lived under a burden of terror. her one desire was to escape from the captured town where the germans had been in authority so many weary months. as nora jamison and bianca both struggled to assist the child, they found she could scarcely help herself, so stiff had she become from her uncomfortable position. yet she managed with their aid to climb up and sit crowded close between bianca and nora jamison. "what are you going to do with this child, sonya?" bianca demanded, more sympathetic than she cared to reveal, remembering her own childhood, which had been more lonely and difficult than any one had ever realized. not even sonya, who had come to her rescue in those past days in italy, more from a combination of circumstance than from any great affection for her, had ever understood. in response sonya bit her lips and frowned. there was something about the little french girl which had attracted her strongly at the first sight of her, an attraction she could not have explained, unless it were compassion, and yet she had seen many pathetic, forsaken children during her war work in france. "i am sure i don't know, bianca," she replied finally. "i suppose we can leave the child with some french family along our route. however, most of them have responsibilities enough of their own, without our adding a child whose last name we do not even know and who appears unable to tell us anything about herself." "we cannot take the child back to her own home, even if we could turn back, which is of course out of the question. i would not have the courage to leave the little girl alone there, when she has showed so plainly her wish to escape. oh, well, life is full enough of problems and some one will surely take the child off our hands! people in adversity are wonderfully kind to one another; our life in france during the war has taught us that much." both sonya and bianca were speaking english so that the little interloper would not be able to understand what they were saying. "i wonder why we cannot take 'la petite louisa' along with us, sonya? after all one little girl more or less won't matter and we may need her for our mascot in the new work that lies before us. i don't know why i feel the red cross nursing with the army of occupation will have new difficulties our former nursing did not have. perhaps because the soldiers will probably not be seriously ill and are likely to be a great deal more bored," mildred thornton urged. sonya shook her head. "mildred, it is a little embarrassing to have to speak of it, but please remember my husband is something of a martinet in matters of red cross discipline. i am afraid he will not think we have the right to add a little girl to our responsibilities. however, the child is with us now not by our choice, and we must make her as comfortable as possible until we have some inspiration concerning her. miss jamison, you will look after her, won't you, since she seems to prefer you?" but already nora jamison had assumed that the care of the little french girl had been entrusted to her as a matter of course. later, the journey through france and into belgium and thence into luxemburg became, not only for the american army but for the red cross units which accompanied it, a triumphant procession. in every little village along their route bells were rung, schools closed while the children and the citizens gathered in the streets to shout their welcome. through the country at each crossroads groups of men, women and young people were found waiting to express their thankfulness either with smiles or tears. thirty-six hours after leaving their hospital near château-thierry, mrs. clark and her red cross workers crossed the frontier of belgium and entered the little town of virton. in virton, at the red cross headquarters, awaiting them they found orders from dr. david clark. as promptly as possible they were to proceed to the capital of luxemburg and there establish a temporary red cross hospital. dr. hugh raymond was to take charge with miss blackstone as superintendent, the red cross nurses assuming their usual duties. before their arrival arrangements for their reception would have been made and a house secured for their temporary hospital. this was necessary since along the route of march numbers of soldiers were being attacked by influenza and must be cared for. ordinary hospitals were already overcrowded with wounded american soldiers who had been prisoners in germany. therefore, obeying orders, this particular red cross unit entered luxemburg a few hours before the arrival of general pershing at the head of his victorious troops. it was early morning when the red cross girls drove into the little duchy, which has occasioned europe trouble out of all proportion to its size. actually the duchy of luxemburg is only nine hundred and ninety-nine square miles and has a population of three hundred thousand persons. just as surely as germany tore up her treaty with belgium as a "scrap of paper," when at the outbreak of the war it suited her convenience, as surely had she marched her army across luxemburg in spite of the protest of its young grand duchess marie adelaide. however, when germany continued to use luxemburg as an occupied province, the grand duchess was supposed to have changed her policy and to have become a german ally. on the morning when the american red cross entered her capital, the grey swarm of german soldiers was hurrying rapidly homeward, broken and defeated, while the american army under general pershing was hourly expected. to make way for the more important reception and to give as little trouble as possible, the american red cross drove directly to the house which had been set apart for their use. the house proved to be a large, old fashioned place with wide windows and a broad veranda, and on the principal street of the city not far from the grand ducal palace. after a few hours of intensive work toward transforming a one-time private residence into a temporary hospital, the entire staff deserted their labors to gather on the broad veranda. the news had reached them that general pershing had entered the capital city of luxemburg and would pass their headquarters on his way to the grand ducal palace for his formal reception by the grand duchess. later a portion of the american army itself marched by. from their balcony the american girls could see the stars and stripes mingling with the red, white and blue of the small principality. never in their past experience had they seen a welcome to equal the welcome given by the citizens of luxemburg to the troops which general pershing had led to victory. if the grand ducal family had been won over to the german cause, how deeply the people of luxemburg had sympathized with the allies was proved by this single day's greeting. together with the people in the streets the red cross workers found they were shouting themselves hoarse. yet the shouts were barely heard amid the blowing of whistles, the ringing of bells. in the hearts of the inhabitants of the tiny duchy apparently there was a great love for the soldiers of the greatest democracy in the world. from every window along their route of march flowers rained down upon the soldiers, children crowding close presented each american doughboy with a bunch of chrysanthemums; one of them carried a banner on which was inscribed, "the day of glory has arrived." turning to speak to mildred thornton who stood beside her, nona davis found to her surprise that her cheeks were wet with tears. she had not been conscious of them until this instant. "it pays almost, doesn't it, mildred, for all the suffering we have witnessed in europe in the past four years to see the rejoicing of the little nations of europe over the victory of democracy? even if the little grand duchess is pro-german in sentiment, it is plain enough that her people must have loathed the german occupation of their country. i would not be surprised if the passing of our soldiers may not mean a change of government in luxemburg. under the circumstances i wonder how long our red cross unit may remain?" mildred thornton shook her head. "impossible to guess of course, nona. and yet i am glad of the opportunity. we shall have nursed in one more country in europe and perhaps even little luxemburg will offer us new experiences and new friends." chapter v _shoals_ during the thirty odd years of her life, sonya valesky, now mrs. david clark, had been through many and varied adventures; some of them, in her young womanhood in russia, had been tragic, others merely difficult. but after a few days in luxemburg, amid the effort to establish the temporary red cross hospital, sonya believed that she had rarely suffered a more trying interlude. it was not the actual work of the hospital arrangements or the care of the sick. of the first miss blackstone took charge and she was eminently capable; for the second dr. hugh raymond was responsible. both of them had able assistants. the upper part of the house was set apart for the care of the officers and soldiers suffering from influenza, and there were about twenty cases; the second floor was reserved as sleeping quarters for the staff with a few extra rooms for patients who were ill and in need of attention from other causes so they should not be exposed to contagion. on the lower floor was a reception room, dining room and kitchen, with the drawing room for convalescents. but as usual sonya clark's task was looking after the red cross nurses, seeing not only that they were in good health, but as happy and contented as possible, giving their best service and in little danger of breakers ahead. nevertheless, within forty-eight hours after the passing of the american troops through luxemburg, it appeared to sonya that some unexpected change had taken place in her group of red cross nurses. what they were actually ordered to do they did in a fairly dutiful fashion, but the old enthusiasm, the old passionate desire for service had vanished. among the entire group of nurses a relaxation of discipline had taken place. the excitement of their journey, the knowledge that the war had ended in the allied victory, a natural desire for pleasure after so long a strain, apparently possessed them alike, except nora jamison who was comparatively new to the work, and seemed in every way an unusual girl. frankly bianca zoli confessed to sonya, not long after their arrival in luxemburg, that she was weary of the endless waiting upon the nurses and patients and needed a short rest. and sonya agreed that this was true. bianca was younger than any member of their red cross unit and had been faithful and untiring in her devotion for many months during the final allied struggle for victory. moreover, bianca also appeared slightly depressed and sonya wisely guessed this was partly due to the long separation from carlo navara, which bianca must see was inevitable. with his regiment carlo was moving toward the rhine and nothing was apt to be less in his mind for the time being than his friendship for the young girl whom he undoubtedly regarded only in a semi-brotherly spirit composed of indifference and affection. since the greater part of the nursing at the temporary hospital in luxemburg was the care of the soldiers who were ill with influenza, and feeling that bianca was not altogether in the right state of health to battle with the contagion, sonya requested miss blackstone to permit her to have a half holiday, doing no work that was not voluntary. but with nona davis and mildred thornton, the two red cross nurses who had given the most valuable personal service, since the outbreak of the war, the situation was more serious and far more difficult to meet. they did not neglect their duties, this would have been impossible to either of them, and yet in a way it was plain that they were no longer wholly absorbed by them and to use an old expression, their hearts were no longer in what they were doing. yet sonya understood; both girls were engaged to be married to young american officers who were at present in the united states. with the signing of the armistice they had hoped to return home. it was possible they had made a mistake in agreeing to dr. clark's request that they remain for a time longer in europe, forming a part of his red cross unit, who were to care for the soldiers of the american army of occupation. with mildred thornton the engagement was comparatively recent. during the latter part of july she had nursed through a dangerous illness, following a wound, an american lieutenant[a] who, together with carlo navara, had crossed into the german lines, securing important secret information, afterwards invaluable to marshal foch. of longer standing was nona davis's romance, which had not been of such plain sailing. in the early months after the entry of the united states into the world war, in an american camp in france, she had met and renewed an acquaintance with lieutenant john martin which had begun as children years before in the old city of charleston, south carolina. soon after lieutenant martin had declared his affection, but believing him arrogant and domineering, nona had not at that time returned his love. later, meeting again upon a united states hospital ship, coming back from france, nona had discovered lieutenant martin, now captain martin, blinded through a gallant action on the battlefields of france. it was then that their former positions were reversed, for captain martin would not accept a devotion which he believed born of pity and declined marrying nona unless his sight were restored. a short time before a letter from new york announced that after an operation, captain martin had the right to believe his sight would be fully regained. therefore would nona marry him as soon as it could be arranged? and nona's answer had been to cable, "yes."[b] however, both mildred thornton and nona davis having already sacrificed so much to their four years of red cross service in europe, had decided to make this ultimate sacrifice in the postponing of their happiness. yet here during the temporary pause of their red cross unit in luxemburg, sonya was able to see that the two girls were finding their self-surrender harder to accept bravely than they had anticipated. whenever it was possible without neglecting their duties they were apt to wander off for mutual sympathy and confidences. even sonya found herself often ignored or forgotten. sometimes she feared that they might harbor a slight resentment, because it was her husband, dr. david clark, who had asked the personal sacrifice. with two other of her red cross nurses sonya had neither much sympathy nor understanding. ruth carroll had never interested her particularly; she was a large, quiet girl, ordinarily a dutiful and fairly reliable nurse, but without special gifts, although as a matter of fact, dr. clark had not shared in his wife's disparaging opinion. however, sonya knew herself to be prejudiced and not so much by ruth herself as by reason of her close friendship with theodosia thompson and the younger girl's undoubted influence upon her. thea had been right in her supposition that mrs. clark neither liked nor trusted her particularly, although sonya herself had scarcely been aware of her own point of view until after the beginning of the journey of her red cross unit toward germany. since then sonya was not at all sure that thea might not prove an uncomfortable if not an actually mischievous influence. one of dr. clark's old students at a prominent new york medical university and afterwards his assistant, dr. hugh raymond, was a young physician in whom the older man had extraordinary confidence and for whom he hoped great things. in the red cross hospital near château-thierry he had done splendid and untiring work. but both sonya and her husband had often smiled over the young doctor's apparent dislike of women and girls. not even with sonya herself had he been willing to be more than coldly friendly. yet since the movement of their unit toward the rhine, sonya had noticed an odd change in him. at first it had appeared as if thea's attempts to make him show an interest in her had simply annoyed him. later she seemed to provoke him. recently sonya believed thea was having a marked effect upon him, sometimes aggravating and at other times pleasing him. and although sonya believed she understood human nature, she also realized that nothing would irritate her husband more profoundly than to discover any kind of personal feeling existing between his nurses and physicians. during all the red cross work in europe from this complication they had been singularly free. moreover, sonya did not consider that theodosia thompson was seriously interested in dr. raymond. it was her personal opinion that thea simply desired admiration and attention, because her nature was restless and dissatisfied. and it was with the two nurses, ruth carroll and theodosia thompson, that sonya had her first real grievance since the beginning of her red cross work. among the patients who had been brought to the temporary luxemburg hospital was major james hersey, who had been in command of a battalion near château-thierry and had been taken ill with influenza along the route of the march toward germany. perhaps major jimmie had been longing too ardently to accompany his picked troops to the left bank of the rhine; however, he was at present pretty seriously ill. all day sonya had been caring for him and at about four o'clock in the afternoon she was beginning to feel that she was growing too tired to be left alone. major hersey was delirious and already it was long past the hour when theodosia thompson had been expected to relieve her. yet she continued to wait patiently, not daring to leave her charge even for a moment. four o'clock passed and then five and no one entered the sick room, not even one of the red cross physicians, and sonya had been expecting a call from dr. raymond some time during the afternoon. at a little after five, miss blackstone stepped in unannounced. she was the superintendent of the hospital and sonya discovered her looking both worried and worn. she was a large, plain, middle-aged woman who had worked with dr. clark for a number of years before his marriage to sonya, and although she and sonya had not liked each other in the early days of their acquaintance, they had become far more friendly since. "i am more sorry than i can say, mrs. clark, not to have sent some one in to help you, but the most amazing thing has happened. just after lunch miss thompson and miss carroll asked permission to take a short motor ride with dr. raymond and dr. mendel. dr. raymond assured me himself that they would not be gone over an hour. it has been much nearer three hours and i hardly know what to do. some accident must have occurred. what do you think we should do?" sonya shrugged her shoulders. "do? why nothing but wait. i have an idea nothing has happened beyond the fact that they have forgotten their responsibilities." footnotes: [footnote a: see red cross girls with united states marines.] [footnote b: see red cross girls afloat with the flag.] chapter vi _the ride_ it was true, as miss blackstone had said, that the little party of four, the two red cross nurses and two physicians, had started out with the intention of taking only a short drive and returning to the hospital in plenty of time for their duties. and in spite of the fact that sonya might be cherishing an unreasonable prejudice, the drive had been proposed by dr. raymond first to theodosia thompson with the suggestion that she ask ruth carroll to accompany them and that he invite dr. leon mendel who was also one of the red cross staff. early in the morning of the same day a note had been sent to the hospital and a motor car offered to the american red cross unit during their stay in luxemburg. as the note had been delivered to dr. raymond he had considered it only courtesy to accept the kindness. he had also been quite selfishly interested in seeing the capital city of luxemburg and the neighboring country and in enjoying a short respite from his continuous work of establishing the temporary hospital. if sonya was annoyed by the young doctor's attitude toward thea thompson, assuredly he was more so. certainly he was not at present under the impression that he actually liked her, only that she had somehow made him realize that he must have always appeared too self-centered and too serious, and that he needed waking up. and certainly thea was stimulating and now and then amusing. this afternoon as he was feeling tired he proposed that she occupy the front seat of the little motor car with him, ruth and dr. mendel sitting in the rear. following no guide except their own impressions they drove through the city, first past the grand ducal palace then the handsome residences of the nobility and finally to the open country on the outskirts of the city. to all four of the occupants of the car it seemed to have had wings, so short a time did their drive absorb. nevertheless thea and dr. raymond had not enjoyed each other particularly. they were both tired and thea was having one of the attacks of depression from which she often suffered. she looked both homely and pale, and even her eyes were less blue beneath their straight, red-brown lashes. only her red hair breaking into irrepressible little waves under her small hat was full of life and charm. reaching the end of the main road from which two country lanes branched off into less inhabited portions of the countryside, dr. raymond turned to speak to ruth carroll and dr. mendel. "i am sorry, it seems to me our ride has scarcely begun, and yet i feel we had best turn back here. we might allow ourselves a little more time but i am afraid if we try one of these unexplored roads we may lose ourselves somewhere." ruth made a little nod of agreement even though her expression revealed disappointment. dr. mendel made no reply. but unexpectedly dr. raymond felt a hand laid lightly on his coat sleeve. "please do go a little further," thea begged. "i wonder if you know that although i am a country girl i have ridden in automobiles only a few times in my life before coming to france." hesitating the young doctor slowed down his car as if expecting to turn around. "i am not in the habit of neglecting my duty for any reason whatsoever, miss thompson. i have just explained that i dared not attempt a strange country road for fear we might go astray and our return to the hospital be seriously delayed." undoubtedly the young red cross doctor's manner was self-righteous and precise, but in answer thea laughed. it was an odd laugh which made him flush uncomfortably. "oh, please do go back then at once!" she said. "nothing would make me ask you to disregard your duty. really dr. raymond, it is a wonderful experience to know any one who so perfectly answers all the requirements of a model character. besides i know you would never do anything because i asked you, although as a matter of fact, we all have the right to our usual two hours off duty this afternoon and less than half of that time has gone by." there was a little sting of bad temper in thea thompson's manner and words which undoubtedly were her heritage along with her brilliant red-gold hair. instead of replying dr. raymond drove his car, not backward toward the hospital as he had announced his intention of doing, but into one of the country roads leading into an entirely unknown locality. it would have been difficult for him to have explained his impetuous action. half an hour later, at the end of a road which led apparently nowhere, dr. raymond stopped his car. "i think i have already managed to lose the way, thanks to you, miss thompson," he announced irritably, "however, i suppose we can simply turn around and go back. certainly this part of the country is entirely uninteresting without a house or an individual in sight. i was very foolish to agree to your request and shall certainly reproach myself if any one has been in special need of me at the hospital. i only trust we may be able to return as quickly as we have made the trip." however, thea made no reply to this reproachful speech except to jump to her feet. "look!" she cried dramatically. "what a perfectly charming picture in that field over there! i told you i was from kentucky and yet i never saw any one ride so beautifully!" naturally thea's companions followed her suggestion. just beyond the end of their road was a wide open field thick with winter stubble. in the centre was a tall hurdle intended for jumping. riding toward this hurdle at a swift pace was a young girl; she was wearing a close fitting, scarlet riding habit, a little dark hat of some kind and high riding boots. her horse was almost equally slim and beautiful, and horse and rider had the suggestion of oneness which is the attribute of perfect riding. there was no other human being in sight. the girl was making straight for the hurdle. evidently she and her horse were both in the habit of jumping for neither showed the least sign of nervousness. breathless with admiration and interest the two american girls and their companions watched. the horse rose in the air, his head a little forward, the rider holding the bridle with just the right degree of freedom and firmness. she was sitting perfectly still, her body in entire accord with the movement of her horse. no one beholding her would have dreamed of an accident. yet when the horse had actually cleared the hurdle without difficulty and had reached the ground on the further side, the girl must have released her hold. in any event she fell forward over the horse's head, one of the front hoofs striking her. first out of the car was thea thompson followed by dr. raymond, then ruth and the other red cross physician. the girl they found to be unconscious from a wound in her forehead. "i don't see why we seem to be in the habit of rescuing people nearly every time i go out in a motor car," said thea. "certainly i never saw so pretty a girl as this one, i hope she is not seriously hurt." dr. raymond wore his most professional air. "it is impossible to say at present," he returned severely. chapter vii _an unexpected situation_ "but i don't wish to leave the hospital, i am comfortable here and mrs. clark says they are pleased to have me. besides i could not possibly be moved just now, i am sure i could not endure it." the young girl who was talking lay surrounded by pillows in a wide, old-fashioned bed in the american red cross hospital in luxemburg. partly from excitement and also because it was characteristic, a brilliant color flamed the girl's cheeks. at present there was a little frown between her dark, finely lined brows. "you must be glad not to have me at home for a time, knowing how we disagree on every important question. and, as for my absence from the palace, i am sure it can only be a relief. you know just how popular i am there at present in the midst of--" the woman who was standing beside the bed, leaning over at this instant placed her fingers on the girl's lips. "don't talk nonsense and under no circumstances speak of so serious a matter where we may be overheard by strangers, my dear child. please realize that the americans are unknown people to us and if there are reasons why it is best we should be cordial, there is an even more important reason why, at present, we should keep our own council. a girl's opinions on matters of state are really not vital, unless the girl chances to be the grand duchess marie adelaide. as her cousin you perhaps take yourself too seriously. but i am not offering you advice, merely telling you that your father desires that you be moved to your own home as soon as your physicians think it advisable. the court physician will call on you at the hospital this afternoon. both your father and i are at a loss to understand how you managed to fall from your horse when ordinarily you are so skilful a rider." the speaker was a severe, elderly person, rather massive, and dressed in a heavy black silk gown, with her white hair piled high under an imposing bonnet and her thin lips drawn into an annoyed line. nevertheless, she managed to keep the tones of her voice fairly even. "naturally enough i realize, charlotta, that you would refuse to be influenced by me, although for that matter you have never been influenced by any one from the time you were a child." the girl bit her lips. "i am afraid i am not well enough to argue at present and my unfortunate disposition, tante, is rather a time-worn subject between us. i shall do no harm here, only rest and have a little peace from our everlasting discussions. besides, you do not seem to consider the fact that i happen to be rather seriously hurt. no one knows how seriously at present, a broken arm and a cut on one's head are not comfortable afflictions, even if they are not dangerous. but the physicians at the american red cross hospital who were good enough to rescue and bring me here seem to believe there may be other complications and that i had best stay where i am for the present. please be as gracious as possible, i have asked mrs. clark to come in this afternoon and be introduced to you. her husband is a prominent american surgeon who has gone on with general pershing toward germany. she is here with a few other red cross nurses caring for a number of american soldiers until they are well enough to be moved. i think we owe her special courtesy as a guest in our country." "i am apt to forget the fact charlotta, or what is required of me, even though i do regard it as unfortunate that the american army should have left us a special reminder of their visit, once having passed through our country." there was an iciness in the manner of the countess scherin which gave one the right to believe that she had no enthusiasm for the american army, whatever personal reasons of state might compel her to courtesy. before replying the young countess charlotta scherin dropped back on her pillows. "if you don't mind, tante, would you mind ringing the bell? i am sure you would prefer seeing mrs. clark in the drawing-room and i am suffering a good deal just at this moment and would like to be quiet. after all you know this house is mine and this bed on which i am at present lying was once my own mother's. if for reasons of state i was allowed to offer my house to the american red cross during their stay in luxemburg, it seems to me like fate that i should be brought here after my accident. but please don't mention to mrs. clark that this is my house. it was offered to the american red cross in the name of the city." a moment later bianca zoli appeared to escort their distinguished visitor downstairs. about to leave the room she beheld an imploring glance in the dark eyes of the girl on the bed and going closer heard her whisper: "do please come back as soon as you can, i don't really need anything except that i am lonely." returning fifteen minutes later, it was then after five o'clock and dusk was gathering in the fine, old-fashioned chamber, so bianca zoli quietly sat down without speaking in the chair which had just been vacated by the elderly countess. the girl upon the bed appeared to be asleep at the moment, but as bianca had no other duty to occupy her it struck her that it might be entertaining to sit in the big, strange room watching her companion and thinking of her story, or at least of its brief outline which was all she knew at present. having witnessed the girl's accident and finding her unconscious and therefore unable to explain her name or identity, it had appeared to both the young american physicians and nurses that the best solution would be to bring her as swiftly as possible to their own hospital. after she had received the necessary attention there would be time and opportunity to discover her family and friends. a few hours afterwards, when the girl herself returned to consciousness, she explained that she was the young countess charlotta scherin and lived with her father and aunt on their estate at a short distance from the city. the greater part of her time, however, she spent at the grand palace with her cousins, the grand duchess marie adelaide and her five younger sisters. she seemed to be in a great deal of pain and yet not particularly unhappy over her accident, only asking that her father be informed that she was in safe hands. and if it were possible and not too much trouble could she remain at the american red cross hospital until her recovery? yet bianca had only considered her companion for a few moments when she became aware that the other girl had opened her eyes and was looking with the deepest interest at her. "i am so glad to have the chance to know american girls," she began. "it may strike you as odd but i have wanted to know them all my life and now through my accident i am to have the opportunity. but you look very young and fragile to have undertaken red cross work during the war. i believe it is the courage, the way in which you go ahead and do what you wish and face the consequences afterwards, that i so much admire." bianca shook her head. "it is odd your saying this to me of all persons, because i used to feel a good deal as you do. you see i am not altogether an american girl; my mother was an italian and my father an american, but i have been living in the united states and i confess i have tried to make myself as like one as possible. but do you think you ought to talk? i'll talk to you if you like, although i am not very interesting; i'm afraid you must be suffering a great deal." bianca made this final remark because her companion was evidently struggling to keep back the tears which had suddenly filled her eyes. "yes, do please talk to me, i am suffering, but i think it is more because i am worried and unhappy than because i am in such pain that i lose my self-control. i have always prided myself on being able to endure physical pain. what are you thinking about?" bianca's large dark eyes which were her only southern inheritance had unexpectedly assumed a questioning expression, although her lips had framed no question. "why, i was merely thinking of how odd life is and how few persons, even young girls are particularly happy. a moment ago i was sitting here envying you because your life seemed so wonderful to me. you have been brought up amid wealth and have a title of your own and live a part of the time in a palace with real duchesses. i suppose my speech does not sound very democratic, yet i think you might find a good many american girls who would envy you for these same reasons." "then they would be extremely stupid," the other girl answered, "because freedom is sometimes the most important thing in the world to an individual as it may be to a state. "suppose, oh, leaving me out of the question altogether, but just suppose that any girl's mother had died when the girl was a baby only one year old. then suppose the child had been brought up by her father and aunt both of whom were twice the age of the girl's own mother. then remember her mother was french and the girl always loved only the things which concerned her mother, had learned to speak her language and had written letters to all her family, but had never been allowed to visit them because the girl's father and aunt believed only in german ideals and in german customs and wished to separate her wholly from her mother's country and people. moreover, they had neither of them ever been able to forgive her because she had not been a boy and so been trained for the army, the german army if possible. then suppose the girl had loved only the outdoors and horses and dogs as if she had been a boy, but because she was a girl had to be trained in all the german ways. as for living in a palace, it is hard sometimes to do and say the proper thing all the time, when you feel they don't believe in the things you believe. oh, i am not saying the fault is not mine--" the girl stopped an instant. "but i was not supposed to be talking about myself, still you must have guessed." "i should not have guessed unless you wished me to guess," bianca replied in the prim little fashion of her childhood which she had never lost from her manner and which amused and pleased her friends. "no, you would not have guessed, you are a dear," the countess charlotta answered with an impulsiveness which was an entire contrast to bianca's nature. "but what i wanted to explain to you is that you were envying what you thought were my circumstances. you were not really thinking of me at all. you see one might be a princess and be very unhappy and one might be a very humble person and just the opposite. then i think we ought to realize that a princess may be very horrid and a beggar maid most wonderful." the young countess hesitated. "i thought that what i have just said is what americans believed. don't they think that human beings are equal and that it all depends on what they do with their own lives, what they are able to make of themselves?" bianca shook her head. "i don't know, you had better talk to some one else on this question instead of to me. i am not at all clever, even my best friends, sonya clark and carlo navara, do not think i am clever. but there is one thing i understand at present. you have told me a great many interesting facts about yourself, but there is something else on your mind which you have not confided to me. it is something which makes you wish you were an american girl because you believe in that case you could do what you like. i think you wish to confide in some one, but can't quite decide. if i were in your place i would try not to worry until you are better, then if you want some one to talk to, don't choose me. i should never be able to give you any worthwhile advice. but talk to mrs. clark, sonya clark. she has had a very unusual life and is one of the most wonderful friends in the world!" the older girl was by this time lying back on her pillows and gazing at bianca with an odd smile. "you know," she said finally, "i would not be surprised if your friends are mistaken in thinking you are not clever. perhaps i shall take your advice. i suppose i had best try now to go to sleep, i am afraid i have already talked too much." chapter viii _the countess's story_ a few days later it had become unnecessary for the little countess charlotta to confide her secret to bianca zoli, or sonya, or to any one else at the temporary red cross hospital in the capital city of luxemburg. already her history had been openly discussed by visitors to the hospital, even by the servants who were assisting with the household work. it was a well-known fact, apparently, that marriage was being arranged for the youthful countess by her father and aunt to an elderly german nobleman. nor was the little countess's opposition to the match, her refusal to consider it as a possibility any more of a secret than the knowledge that no attention was being paid her protests. inquiring the name of the girl who might be regarded as the prettiest and the most wilful among the daughters of the noble families of luxemburg, one undoubtedly would have been told, charlotta scherin. during the past four years perhaps her mixture of german and french blood had been a disturbing inheritance. shortly after the passing of a portion of the american army of occupation through the little country, many were the rumors and talks of political changes and readjustments which would probably take place, but to these the small american red cross unit decided to give little heed. one thing they were obliged to hear, the grand duchess marie adelaide had not pleased all her subjects by her surrender to german ideas and designs during the recent years when the german army had used her kingdom as a passageway to france. in spite of her verbal protest against the breaking of the treaty which declared her country neutral, once the germans had entered her duchy the grand duchess had appeared to sympathize with the invaders. now, whether it was the world talk of democracy, the victory of the allies, or the old love of the little duchy of luxemburg for france, the people of the small kingdom were assuredly considering a change of government. yet this problem did not trouble or affect the affairs of the red cross hospital. nor did the little countess charlotta appear deeply interested, insisting that her family would make the same effort to compel her marriage without regard to political reforms. certainly the young luxemburg countess, whatever her upbringing, was not a reserved character. instead she seemed to love nothing so well as to discuss her own past, present and future with the group of american girls and to have them tell her as much as they would of their own histories. one way or another apparently the countess charlotta was in the habit of managing to do what she liked. the thing she wished at present was to remain as long as possible at the american red cross hospital. it was true at first the two red cross physicians who had been her rescuers advised against her removal from the hospital. influenced by them, or perhaps sharing their view, her own physician had given the same opinion. but now a number of days having passed without fresh complications, undoubtedly the countess charlotta might have returned home had she so desired. yet since she did not so desire and declined to stir from her bed, naturally sonya felt obliged to insist upon her remaining until she had completely recovered. the old house in which the red cross was now established sonya had since learned was the property of the girl who was in a sense an accidental patient. the countess charlotta was not a troublesome invalid, sonya's chief difficulty being that the red cross girls so enjoyed the newcomer's society it was difficult to keep them out of her room during any of their spare moments. certainly she was brave and made as little as possible of her physical suffering, and then her insatiate curiosity about american girls was a charm in itself. as a matter of fact it was charlotta who soon knew more of the history of the present group of red cross girls than any one of their number had ever formerly known. both mildred thornton and nona davis told her of their own engagements, perhaps unwisely sympathizing with the difference in their own futures and hers. bianca zoli spared nothing of her past save the betrayal of her country's secrets by her italian mother, a fact to which she never alluded. sonya even discovered herself relating anecdotes of her own somewhat long and checkered career for the benefit of the newcomer who was at once the guest of the hospital and its hostess. she even spoke of her recent marriage to dr. david clark and the fact that his red cross unit would establish a hospital in one of the old castles on the rhine as soon as the american army of occupation were in possession of coblenz. ruth carroll reported that she had not so interesting a story to tell as she knew the little countess would have liked to hear. her life had been fairly prosaic; her father was a country doctor in a little kentucky town and she had never left home until the interest in the war led her to study nursing and later to join the red cross service in france. regardless of charlotta's openly expressed unbelief, ruth insisted that never in her life, not even as a little girl, had she possessed a real admirer. in compensation ruth could only declare that if theodosia thompson cared to tell of her past it would form a contrast to her own humdrum tale. it chanced that bianca zoli was also in the little countess's room when one evening after supper theodosia dropped in to rest and talk before going upstairs to bed. her duties were over for the day and it seemed to both the other girls that she appeared tired and cross. yet the work at the hospital at present was not severe. most of the american soldiers, who had suffered attacks of influenza on their eastward march, were now nearly well, while a few of them had already left the hospital at luxemburg for one of the convalescent hospitals in southern france. in their brief acquaintance bianca and charlotta had become intimate friends, for one reason because bianca had more time to devote to her than the regular red cross nurses. but there was another strange bond in the difference in their temperaments, since concealment of her emotions was the habit of bianca's life, while charlotta apparently never concealed anything. yet bianca was talking of carlo navara and their friendship when theodosia interrupted her unconscious revelation of her affection for the young american soldier and singer. "perhaps you would rather i did not come in," theodosia protested, standing a moment on the threshold and frowning. then, when both girls had insisted on her entrance, she came and sat down in a large chair with her small feet thrust under her. bianca was sitting on the edge of charlotta's bed, both of them having been examining a box of jewelry which the young countess had demanded sent from her home earlier in the day. the big room was very comfortable with a few pieces of old furniture which had not been removed from this chamber to give place to the regular hospital accommodations. a shaded electric light was on a table near the bed throwing its warm lights on bianca zoli's fair hair and on the countess charlotta's black curls which she had tied with a band of bright blue velvet. "you children look very young and very fortunate," theodosia began, her tone a little envious. "it must be agreeable, countess charlotta, not to be a miss nobody of nowhere, even if you have difficulties of your own to contend with." theodosia made a queer little face, wrinkling her small nose, the dark light appearing in the centres of her large, pale blue eyes. "i don't think i could make up my mind even in my present condition to marry a german nobleman, but a nobleman of another variety i think i would accept regardless of his age and the democratic ideas which are supposed to possess my country. as a matter of fact, i don't suppose any girls in the world ever wanted to marry into the nobility more than american girls before the war. i rather wonder if we have altogether changed. but at any rate i have nothing to offer to anybody, neither beauty, nor brains, nor money, nor family." then observing that both her companions appeared shocked by her pessimism theodosia laughed, her expression changing with extraordinary swiftness. "i wonder if you girls would like to hear a little of my history. i hope you won't be bored. after all it is only fair that we should know something of each other before we can form fair judgments. i wish i had the courage to confide in mrs. clark, but i don't think she likes me. "i might as well tell the worst or the best of myself first. my mother was a dancer. i don't know much about her except that she was ill and came to a little kentucky town to try to recover. my father was a boy, younger than she, and fell desperately in love. he married her without a cent and against the will of his older brother, a small farmer. well, my mother died and my father died soon after when i was a few years old. afterwards i was brought up by a very unpleasant old uncle of the story book variety, who disliked me and everything about me. "i never had any friends except ruth carroll, who is an angel and has always been good to me. people in little towns are still suspicious of an ancestry like mine. i want to be a dancer myself, but i have never had the opportunity. so i studied nursing because ruth was studying and because i wanted to help in the war and most of all, to get away from cloverport, kentucky. "there is my history in a nutshell, but what is really interesting in life isn't the chapters one has already read, it is the chapters to come. i hope we may soon go on to coblenz. i am sure we will have an interesting time there. only of course i am sorry, countess charlotta, that you will not be with us." older than her companions, theodosia's dramatic irish instinct was somewhat overwhelming. even the little luxemburg countess felt her own story of less interest and importance by comparison. fortunately theodosia had also an irish sense of humor and observing the awestruck expressions of her companions, suddenly she laughed a gay little laugh which was one of the attractions of her odd and not always pleasing personality. "oh, you must not take what i have just told you too seriously. ruth carroll, who understands me better than any one else, says i get more pleasure than sorrow out of my queer history. as for the dancing i only wish to do folk dancing and mrs. clark tells me the soldiers are beginning to be interested in folk dancing as one of the methods of amusing themselves. i told her how much i was interested and she told me there might be a chance to help entertain the soldiers as well as nurse them, after the army of occupation settles down for a long watch upon the rhine. goodnight," and even more quickly than she had appeared, thea, as her friends called her, slipped out of the big chair and disappeared. a few minutes later bianca went her way to bed. she was wearing a small pin which the countess charlotta had given her, not only as a mark of her friendship, but for a secret reason which only the two girls were to know. so it chanced that the group of red cross girls and the little luxemburg countess became fairly well acquainted with each other's past histories because of the natural fondness of girls for confiding in one another. only nora jamison never talked of herself, and though appearing perfectly friendly, seemed to devote all her spare time to the companionship of the little french girl, louisa. chapter ix "_life's little ironies_" one afternoon the countess charlotta was alone in her room walking up and down in a restless fashion for a girl who had been so recently injured. her forehead was still bandaged and her arm in a plaster cast, but otherwise she was apparently well. nevertheless, she showed the results of the strain of her accident and perhaps of her personal problem. she looked older than one would have supposed from her half-joking and half-serious conversations with bianca zoli and the other red cross girls. in spite of her natural gayety and the warmth and color of her nature, which she had inherited from her french ancestry, the girl faced a difficult future. all her life it seemed to her she had been in opposition to her surroundings, throwing herself powerlessly against ideas and conditions she could not alter. everything that belonged to the old german order of existence she had always hated. from the time of her babyhood her father had appeared to her as a narrow tyrant insisting that she should spend her days in a routine which pleased him, without consulting either her wishes or her talents. as a matter of fact, the small countess had a will of her own and resented dictation. never would the little charlotta even in her earliest youth do what might naturally have been expected of her! from the first her wilfulness, her entire lack of interest in ladylike pursuits had been a source of trouble and anxiety to her governesses. one characteristic of the small charlotta was that she never seemed able to remain still long enough to learn the things which were required of her. her one desire was to be outdoors riding on horseback over the fields, or playing with the children in the village, or in the small cottages on her father's estate. the dignity and importance of her own social position never seemed to enter charlotta's mind, even after her family had devoted long hours to bringing the fact before her attention. reaching sixteen it had become her duty to play a small part in the little court of her cousin, the grand duchess. but although the court life was simple and far less formal than in countries of greater wealth and size than the little duchy of luxemburg, nevertheless charlotta found even the mild formalism irksome. the real difficulty lay in the fact that the members of the grand duchess's court were germans in thought, in ancestry and in their ideals. now the little countess charlotta faced a life when she must always remain surrounded with these same influences; influences that she hated and that had always repelled and antagonized her. what matter if the germans had failed in their war against freedom, if her own freedom was still denied her? moreover, since the german failure her father appeared more than ever determined to force her marriage. if the german nobility were in disgrace, if the men surrounding the kaiser had fallen with their master from their high estate, at least the count scherin of luxemburg was faithful to old principles. luxemburg was a neutral state and there could be no interference with his personal ideas and designs. moreover, a few moments before the countess charlotta had received her father's ultimatum and had just concluded the reading of his note which demanded that she return home within the next thirty-six hours. well, she would be more sorry to say farewell to her friends than they would ever appreciate. besides, she must go away from the red cross hospital without the inspiration and the aid she had hoped to receive from her contact with a group of american girls. how much she had hoped to learn from the example of their courage. surely some of them must have broken away from family traditions in coming from their own homes into foreign lands to nurse the wounded! and she had dreamed she might learn to follow their example. but how quiet the house seemed at present. it was strange to recall that her accident had brought her to this house where her mother had lived as a girl, a house which had been a part of her inheritance from her mother, although she had rarely been inside it. if only one of the red cross girls would come and talk with her. there was so little time left when this would be possible and she so dreaded her own society. what would she do when she returned to the old narrowness of her past existence with the eternal disagreements? never except when she was outdoors could charlotta endure being alone. for the first time since her accident the little countess was almost completely dressed in a brown costume which bianca had with great difficulty adjusted over her injured arm. walking to her door charlotta opened it, glancing out into the wide hall. if she had thought to mention it to mrs. clark, she would surely have gained permission to wander over this floor of her mother's former home. as a matter of fact, she had not been inside the place for a number of years, as the property she had inherited from her mother was in the hands of a business agent. stepping out into the wide hall charlotta started toward the front window which overlooked the grounds. in a moment, however, she saw that the space before the window was occupied by a wheeled chair and that an american officer was seated there letting the sunlight stream over him. undismayed charlotta walked forward. "you have been ill and are better, i am glad," she said simply. she had a curious lack of self-consciousness and a friendliness which was very charming. the young officer attempted to rise. "why, yes, i am better, thank you. i have been stupidly ill from an attack of influenza just as my men were on the march toward germany and i should have given anything in the world to have been able to go along with them. however, i must not grumble. i am right again so you need not be afraid of me. we have been kept pretty well isolated from you. but won't you have this chair?" the girl shook her head. "you are very kind and you can be quite certain i am not afraid of you. sit down again, i know you will refuse to confess it, but you do look pretty weak still. and there is nothing the matter with me. oh, i have a few bruises and a broken arm, but after all they are not serious. i wonder now what i was actually trying to do when i flung myself off my horse. have you ever been desperate enough not to care what happened to you?" "but you don't mean, countess charlotta--" "how do you know my name?" the girl answered quickly, as if wishing to forget what she had just confessed. "are you not major james hersey, one of the youngest majors in the united states overseas service? i think i have been hearing a good deal of you from bianca zoli and the other red cross girls." major jimmie hersey colored through his pallor, according to his annoying boyish habit. "well, countess charlotta, surely _you_ have not counted on remaining a mystery--not to the american soldiers who have been ill here in your house, your guests in a fashion. we have seldom had so romantic an experience as having a countess as a patient along with the american doughboys and in the selfsame hospital. but i really can't sit here and talk to you while you stand. at least you will let me bring you a chair?" with a good deal of satisfaction charlotta nodded her head, her hair showing even duskier in contrast with the white bandage over her forehead. talking to american girls she had found extraordinarily entertaining, but to talk to a young american officer might be even more agreeable. it certainly would be a novelty, as this youthful major was the first american man with whom she had ever exchanged a word, save the two young american red cross physicians. "i want to congratulate you on your victory," charlotta added, when the chair had been secured and she had seated herself upon it in an entirely friendly and informal attitude. "always my sympathies have been with the allies from the very first. you see my mother was french and i suppose i am like her. i believe french people have the love of freedom in their blood just as you americans have." "i say, i thought there was something unusual about you," major jimmie answered impetuously. "i really can't imagine your being even half german. but that is not very polite of me and anyhow your country is not german. i have been reading about luxemburg. you were once a part of france and after the french revolution became one of the ten departments, known as the department of forests, the forest canton. except for your grand ducal family you have never been german in sentiment." the countess charlotta hummed the line of a popular version of the national anthem of luxemburg at the present time. "prussians will we not become." then as she could not help being confidential she added: "but suppose, suppose you were going to be forced into a german marriage, what, what would you do? i hate it, hate it, and yet--" "well, nothing on earth would induce me to consider it," major jimmie answered, his brown eyes shining and his face a deeper crimson. "you must forgive me, but you know i can't see anything straight about germany yet and the thought of a girl like you marrying one of the brutes,--but perhaps i ought not to say anything as we are strangers and i might be tempted into saying too much." "you could not say too much," charlotta returned encouragingly. "i wish you would give me your advice. if i had been a boy i would have run away and fought against germany and been killed, or if i had not been killed perhaps my family would have cast me off. i am thinking of running away anyhow, only i don't know just where to go. do you think i could get to america without being discovered? perhaps i might dress as a soldier. you see i can speak english and french and german. i had to learn languages as a child even when i hated studying and now i'm glad. then you know i can ride and shoot pretty well. i don't know why my father ever consented to have me taught, save that it amused him a little to have me show the tastes he would have liked in a son." major hersey felt himself growing a little confused, as if he were losing his sense of proportion. he was not much given to reading, but he remembered two delightful romances, one "a lady of quality," the other "the prisoner of zenda." here he was finding the two stories melting into one in the person of the girl beside him. well the situation was surprising even a little thrilling! yet major jimmie knew what his own ideals required of him. "i am sorry, i am afraid i don't dare offer you advice. haven't you some woman who is your friend to whom you could appeal? there is mrs. clark; i have been knowing her some time when i was in camp not far from her red cross hospital near château-thierry. why not talk to her? still, if i were you i would not try running away, certainly not to the united states. it is pretty far and you could never make it. excuse me, but you know it is amusing to hear you talk of dressing as a soldier. i am afraid you would not get away with the disguise five minutes. wonder if you have half an idea what a soldier has to undergo before he can get aboard a transport for home." the young american officer laughed and then his expression grew serious. "please don't say a thing like that again, even in jest and please don't even think it. i know a girl who has been brought up as you have been thinks she knows something about the world, when in reality she knows nothing, anyhow, nothing that is ugly or real. i say, here comes mrs. clark now, why not ask her to help you?" at this moment sonya clark was advancing down the hall to escort her patient, major james hersey, back to his own room. a little surprised on discovering the intimacy of the conversation, which was undoubtedly taking place between the young officer and the girl who had certainly not known each other half an hour before, sonya stopped and looked toward them. then she smiled at the little picture they made together and came forward to join them. chapter x _the talk with sonya_ "but, my dear child, surely you must see my position! the red cross unit of which i am a member has asked the hospitality of your country in order that we may care for a number of our ill soldiers until they are sufficiently recovered to be sent away. i am deeply sorry and troubled for you. but how can i show my appreciation of the courtesy--and i know our continued presence in luxemburg has been an embarrassment--by a betrayal of confidence? it would be a betrayal if i were to aid you in getting away from your home and country without your father's knowledge. in a way it would not only be a personal discourtesy and deceit, there might even be international difficulties. you are related to the grand ducal family while i, well, very unimportant persons can make important difficulties these days! so i am afraid i must refuse what you ask. but surely if you speak plainly to your father and make him understand your feeling in the matter, he will not demand a sacrifice of your youth and happiness. of course i don't know the laws or the customs of your country, but an enforced marriage these days appears as an impossibility." "it is not a question of law or custom, mrs. clark; only in reigning families are marriages actually arranged," the countess charlotta answered. "of course you know, however, that in germany the consent of the parents to a marriage is almost essential, and my father is german born and was brought up in germany, coming to luxemburg when he was near middle age. but i am not trying to pretend to you that i am actually being forced into this marriage, since in the end in spite of my pretence of bravery it will be my own cowardice which will condemn me to it. i simply do not feel i can go on living at home with my father and aunt if i refuse my consent. all my life i have been a disappointment to them and the atmosphere of our existence has been one long disagreement with antagonism between us on every possible subject. you see i have a good deal of money in my own right and the man my father wishes me to marry is an old friend of his, who has lost his fortune through the war. my father is very bitter over the result of the war, even if he may be forced to pretend otherwise. i think he wishes to give my fortune to his friend as much as he wishes to see me a proper german wife. but don't worry about me, mrs. clark, i _do_ see your point of view and am sorry to have troubled you." it was past the usual hour of bed-time in the red cross hospital and sonya had come in to talk to the young luxemburg countess on her way to her own room. she got up now and began walking up and down, feeling worried and uncertain. the young countess's situation, her beauty and charm, made a deep appeal and yet she was powerless to do what she asked and help her to escape from her uncongenial environment. the girl's suggestion had been singularly childlike. she wished to be allowed to go away from luxemburg with the red cross girls secretly and to remain in hiding with them. "i am not a useful person at present," she had pleaded, "i think because i have never wished to be, but as soon as my arm is well i am sure you will find, mrs. clark, that i can do a good many things that might be worth while. it would not be red cross work perhaps, but i could help with the translating, i suppose there may be a good deal of confusion of tongues when the army of occupation reaches the rhine." sonya was thinking of this speech now as she watched the shadows in the old room, lighted only by a single lamp. a curious freak of circumstance that this same room had once been the countess charlotta's mother's. "do you think i might talk to your father? would it do the least good? i suppose he would only think me extraordinarily impertinent?" sonya queried. in the years of her work with the red cross since the beginning of the war perhaps she had had a singular experience. instead of finding as most women had, that she had given herself wholly and entirely to the needs of the soldiers, it seemed to sonya that the greatest and most important demands upon her had been made by the red cross girls. always it was young girls who came to her with their problems, their disappointments and difficulties. and sometimes the difficulties were associated with their work, but more often with their emotions. but then it seemed that love and war had always gone hand in hand, and at least the girls she had cared for had kept themselves free from unfortunate entanglements. the soldiers they had chosen for their friends were fine and generous. but with the little luxemburg countess, sonya felt it might be difficult to guess what her future might hold. she was wilful, beautiful and unhappy, with perhaps but few congenial friends among her former associates. at this instant the countess charlotta shook her head, smiling. "no, i don't think it would do any good for you to talk to my father, mrs. clark. as a matter of fact, it would make things more difficult for me to have him discover i have discussed my private affairs with a comparative stranger. i shall probably say goodby to you tomorrow and go back home, but i want you to realize, mrs. clark, how much i have appreciated everybody's kindness to me here and how much i like and admire american girls. indeed, i would not have added to your work if i had not been so anxious for their acquaintance. you will soon be going away from luxemburg to join the american army of occupation on the rhine. may i wish you all good fortune?" the little countess held out her hand and sonya took it in her own for a moment and then leaned over and kissed her. "may i write you after we go away and tell you where we are to be stationed? surely there could be no objection to this. and, my dear, some day i may be able to prove myself your friend, even if i am forced to seem unfriendly now. goodnight." and sonya went away, curiously depressed. in a few days the temporary red cross hospital in luxemburg would close and she would probably never see the little countess charlotta again. the soldiers who had been ill were now sufficiently recovered either to rejoin their regiments, by this time approaching the german frontier, or else to return to convalescent hospitals in france. the reigning family of the little duchy of luxemburg had been courteous but none too friendly, and personally sonya was anxious to rejoin her husband and the remainder of their red cross unit and to find themselves established with the american army of occupation. gossip in luxemburg at the present time insisted that the grand duchess marie adelaide would probably be deposed and her sister invited to reign in her place. sonya was hoping to be away from the duchy before this occurred, and as this did not actually take place until early in january and it was now december, the american red cross unit had not to meet this political change. left to herself the little countess charlotta did not go immediately to bed, although bianca zoli had helped her to undress some time before and she now wore only her rose-colored velvet dressing gown over her night gown. until it was midnight and the big house had grown quiet she sat alone. her future was at present no clearer before her than upon the day when in a spirit of utter recklessness and foolhardiness she had deliberately flung herself from her horse. yet at least she would never be so stupid again or perhaps so wicked! finally getting up she lighted a candle and wandered first about the old room and then out into the wide hall. she had an idea of going to bianca zoli's room and of asking bianca if it were possible that she could make her a gift, an unusual gift perhaps. the little countess desired one of bianca's cast-off red cross uniforms. but then bianca did not sleep alone and would certainly be startled by such an extraordinary request. moreover, charlotta would have no reasonable explanation to offer for her request not being entirely clear in her own mind as to why she desired this possession. later she tiptoed back into her own room and climbed into bed. next day probably she would make her singular demand. if she had no such opportunity at some time, when the american red cross had departed from luxemburg, she would come back to her own house, since there she might find what she wished. if it became necessary and she did finally decide to leave home she would require some disguise which her friends might unwittingly leave behind them. chapter xi _the journey to coblenz_ "i want a doughboy and not an officer to be first across that bridge." this command from an american officer was issued one morning in december, just as the sun broke through the grey mist. a little later, the american army of occupation, which had been led to victory by general pershing, crossed the moselle river. beyond lay germany. there was no loud cheering, no blare of bands, or signs of the conquering hero, when the american soldiers set foot on the land they had crossed the ocean to conquer, only before their eyes floating in the morning breeze were the stars and stripes. the advanced guard continued the ascent over winding roads and past villages onward toward the rhine. first marched the infantry, then followed the artillery, engineers, signal battalions and last the hospital units. and accompanying one of the final units was sonya clark and her red cross group. never were any of them to forget their journey into the city of coblenz, which, situated midway between mayence and cologne, just where the moselle flows into the rhine, was to form the chief city for the american army of occupation. as a matter of fact sonya and her red cross unit had not dreamed of being able to form a part of the army on their first approach to the rhine, believing that the time spent by them in luxemburg would delay them too seriously. but, because the german army was slower in accomplishing its retreat than had been anticipated, the third american army did not draw near the city of coblenz until the close of the second week of december. it was sunday when they started their victorious march from the french country, it was sunday when they entered the valley of the rhine. every acre of the valley appeared to be under cultivation; there were fields of winter wheat and walled vineyards lining the roads. beyond, the hills were covered with dense forests, farther on were the tall summits of the ancient castles of the rhine. varying impressions the journey into germany made upon this particular group of american girls. "i declare it is unendurable to me to see how prosperous and peaceful the german county appears in comparison with the french!" nona davis exclaimed, staring out of the window of their red cross automobile, as their car drove through one of the small towns not far from the larger city. not many grown persons were in sight, but children were swarming everywhere and blonde heads were sticking out of the windows of nearly all the little houses along the road. "i don't think the children look nearly as hungry as we had been led to expect," she added with a bitterness of tone unlike nona's usual attitude of mind. but then she had been nursing in europe for four years, since the very outbreak of the war and had been an eyewitness to untold suffering and privation. "i don't think i would be resentful about the german children, miss davis," nora jamison argued unexpectedly, as she rarely took part in any general conversation among the red cross girls. nona glanced in her direction. sitting next nora was the little french girl, louisa, who had been in her care ever since their withdrawal from france. there had been no one along the way to whom they could entrust the child. in the little french girl's expression at the moment there was something which seemed to nona to justify her point of view. her face was white and her lips trembling as she too gazed out at the little german village. at the instant she had beheld a former german soldier walking along one of the streets. on his head was a round civilian cap and he had on a pair of civilian trousers, the rest of his costume was an old german uniform. and it was the sight of the uniform which had brought the terror to the child's face. sonya saw the look and understood it at the same moment. in order that there might be no further argument she said gently: "girls, i don't often preach, but perhaps i shall make the effort now. we are going into an extraordinary new experience for which i sometimes wonder if we are either mentally or spiritually prepared. during the past four years we have felt an intense bitterness against everything german; they represented for us all the forces of evil against which we were fighting. now we are going to live among them and i suppose must not feel the same degree of hatred. yet it will be difficult to change, impossible at first. i think it may be a number of years before we can learn to accept them as our friends. and yet i do not wish any of us to stir up fresh antagonism. one has always heard that the soldiers who have done the actual fighting have never the same hatred toward each other as the noncombatants, and perhaps we red cross workers stand somewhere in between the two. and yet germany has only herself to thank that she has earned the distrust of the civilized world!" as no one replied, after remaining silent a moment, sonya went on: "you know our soldiers have been given the order that they are to be as polite as possible and not to make trouble, but also they are not to fraternize with the germans, even if living in their homes. i think the same order holds good with us." at this instant bianca zoli who had appeared to be almost asleep opened her eyes and yawned. "but i thought fraternizing meant becoming like brothers," she remarked irritably. "i don't see how there is any danger of our becoming too brotherly with the germans, sonya." the laugh at bianca's speech, although annoying to her, helped to clear the atmosphere. in truth at the time the red cross girls were weary and anxious to reach the end of their journey, in order that they might establish their red cross headquarters. bianca was in a particularly discouraged frame of mind. she was distinctly grieved at saying goodby to the little luxemburg countess, whom she happened to have liked more than any girl she had ever known; she also cherished a grievance against sonya clark, because sonya had refused to consent to bring charlotta away with them secretly. moreover, bianca was anxious to have some word of carlo navara. not a line, no news of any kind had she been able to receive since carlo's regiment began its march toward the rhine. and bianca had never a very comfortable sense of carlo's enduring friendship. it was only when she had been able to help carlo in the past that he had seemed especially fond of her. she did not blame him particularly; he was a good deal older than she was, and his gift of a wonderful voice made other people spoil him, beside adding to his own vanity. he had once thought he would always care more for sonya clark than any one in the world, but bianca had seen in the last weeks they were together in the hospital near château-thierry that carlo was becoming far more reasonable upon this subject. sonya's marriage had of course made all the difference, although in his absurd fashion carlo had protested that it could never alter his affection. with a little sigh, bianca now made an effort to go to sleep again. she was not in the least interested in continuing to stare out the car window as the other girls were. she had been doing nothing else for days. whether she slept or not, bianca did not realize. but suddenly she heard sonya murmur. "don't go to sleep again, bianca dear. we are just about to enter coblenz and i want you to remember it all your life. see it is a splendid, prosperous city along the bank of the rhine." but bianca would not rouse herself until their automobile had entered the centre of the city and gone by the coblenzhof, one of the finest hotels in the city, and then past the mammoth statue of wilhelm i the grandfather of the deposed kaiser. then bianca decided to display a mild interest in her surroundings. coblenz is known as one of the most beautiful cities in the world and the german defeat had dimmed none of its outward glory. finally the red cross automobile drove to the outskirts of the city and entered a large court yard. on a hill beyond the courtyard rose an old castle which was to be the new american red cross hospital. the building itself was grim and forbidding with its square, serrated towers and heavy, dark stone walls. bianca gave an instinctive shiver. "the castle looks more like a dungeon than a hospital," she whispered to sonya, "i wish they had given us a more cheerful place for our headquarters. perhaps our soldiers will not mind, but i should hate to be ill in such a dismal place. yes, i know the outlook over the rhine is magnificent but just the same it depresses me." then bianca's manner and expression changed. standing in the yard before the castle were a group of their friends waiting to receive them. dr. clark had arrived in coblenz a number of hours before his wife and had already taken command of the new red cross hospital for american soldiers. he and his wife had not seen each other in nearly a month, as they had made the journey to the rhine with different portions of the army. with dr. clark were other members of his red cross staff and several representatives of the german red cross, who were to turn over certain supplies. unexpectedly a private soldier formed one of the group, who must have received permission from his superior officer to share in the welcome to his friends. the young man was carlo navara. bianca extended her hand like a child for carlo to assist her out of the car. "i was never so glad to see you before," she announced. "i don't care what the other red cross girls may say, but i have found the journey to the rhine since we left luxemburg extremely tiresome." chapter xii _new year's eve in coblenz_ there was no great difficulty in establishing the american red cross hospital at coblenz. dr. clark had a large and efficient staff who were accustomed to working with him and naturally the demands were not so severe as in time of war. indeed dr. clark had no idea of asking the same degree of energy and devotion which the last six months of fighting had required of every human being in any way engaged in the great struggle in europe. a reasonable amount of work and of discipline was as necessary for the hospital staff as for the soldiers and officers of the american army of occupation engaged in their new duty of policing the rhine. yet whenever it was possible opportunity was given for freedom and pleasure. there were but few of the expected difficulties between the americans and the germans which the people of both nations had feared. a certain friction of course and suspicion and gossip about secret plots, but no open quarreling or dissension. the new red cross hospital occupied an old castle which had formerly been used as a german hospital, although the last german wounded had been removed before the arrival of the american army. the castle itself stood on a hill with a drop of a hundred feet to the bank of the rhine, a path led down the hill to the river's edge. crowning the summit were two old roman towers which commanded a wonderful view; through the windows one could see many miles up and down the historic stream and on either side other castles famous in ancient legends long before the foundation of the modern german empire. within view of the american red cross hospital was the famous german fortress of ehrenbreitstein across the river from coblenz. the fortress was set on a rocky promontory four hundred feet above the river and surrounded by a hundred acres of land. from its flagstaff, where for a hundred years the german standard had waved, now floated the stars and stripes. on new year's day at about four o'clock in the afternoon sonya clark stood waiting just outside the hospital for the appearance of her husband. it had become their custom for the past two weeks, whenever there was no real reason to prevent, to take a walk every afternoon at about the same hour. however, on this afternoon, sonya and dr. clark had a definite destination. a new year's eve entertainment for the amusement of the soldiers was to take place at the red cross headquarters about a mile from the hospital and both sonya and her husband had promised to be present. as a matter of fact as many of their red cross nurses as miss blackstone had been able to release from their duties had been spending the afternoon at the headquarters and an equal number of the hospital staff of physicians and orderlies. a light snow was falling when sonya and dr. clark set out. the court yard in front of their hospital sloped gradually to the road, so that the steep incline was only in the rear. to her husband at least sonya looked very young and handsome in her long fur coat and hat, which had been one of his gifts since reaching europe. their walk was to lead through a number of quiet streets and then along one of the main thoroughfares of the german city. at first sonya and dr. clark spoke of nothing of any importance and then finally walked on for several moments in silence. at the end of this time, sonya glanced toward her husband and smiled. "what is it you wish to talk to me about?" she inquired. "i don't know why, but i always seem able to feel a something in the atmosphere when you have a problem on your mind which you can't quite decide to discuss with me." dr. clark laughed. "well, you see, sonya, when i married you i was under the impression that you were unsuited to red cross work and that so far as possible, since you would insist upon working with me, you must be saved from as many difficulties as possible. at present, although i have not yet quite reached the state of advising with you upon my professional responsibilities, when my problems are human, you are the only person to whom i can turn. miss blackstone is an admirable superintendent of a hospital along the same lines that i have been a fairly successful physician and surgeon, but when we have to deal with personal equations we are both hopelessly unfit." "and all this long speech, which may or may not be complimentary, leads up to just what human equation at present?" sonya queried. "can't you guess and tell me first, sonya?" dr. clark demanded. "i always feel so much better satisfied if you have noticed certain situations yourself before i speak to you of them. then i am convinced that i have not made a mistake in my own sometimes faulty observations." "i suppose at this instant you are considering the problem of hugh raymond and thea thompson, aren't you, if problem there is in which any outside human being has a right to interfere? no, don't interrupt me until i finish," sonya protested. "i realize that you are very seriously opposed to the least personal relation existing between any of your red cross nurses and physicians and so far we have been remarkably successful. but it has been more luck i think than my distinguished husband's objection to the possibility. one can't arrange, when young persons are more or less intimately associated with each other and living under the same roof, that they always maintain a friendly and yet highly impersonal attitude. of course i also understand that you have great hopes for hugh raymond's future, and that as he is extremely poor you would dislike to see him marry a poor girl before his position is more assured. i also understand that neither you nor i especially like thea thompson. she has rather a curious history and is not herself an ordinary person. one thing i have noticed. at the beginning of their acquaintance it was thea who made an effort to interest hugh, since then i don't think she has been particularly interested in him. the interest has been on his side. it is to me rather unfortunate because ruth carroll might have liked hugh, and, oh well, i must not speak of this! all i wished to say was that whatever our personal feeling in the matter it will be wiser, my dear husband, for you to say nothing to hugh at present and for me to say nothing to thea, which is what you rather had in mind to suggest. moreover, nothing has so far developed between them for which you need have cause to worry! thea told me the other day that she was happy here in coblenz because she has been able to have a relief from the constant strain of the hospital work, which she confesses was becoming a little hard to endure, by dancing with the soldiers at the red cross headquarters in her free hours. she has been helping one of the red cross managers, a mrs. adams, to teach some of the soldiers folk dancing. i believe she has a gift for it and the soldiers are getting a good deal of amusement out of their own efforts to learn. a good thing for all of them! we must remember our years and realize that young people need all kinds of relaxation." "thanks, sonya, for including me along with your youthful self, even if we are in a class apart," dr. clark returned. "i wonder if you will be as severe with me concerning my other complaint. as a matter of fact i am ashamed of this myself and do not honestly consider it gravely. but you know we are in a curious position here in coblenz. on the outside apparently everything is going well. as comfortable a relation as one could expect has been established between our former enemy and ourselves. yet coblenz is full of rumors. there is a very strong pro-kaiser element in the city, which means there is a party deeply in opposition to all american thought and feeling and to the establishment of any new form of government in germany which shall not include the kaiser. "the point of all this is that i insist there be no display even of conventional friendliness between any member of our red cross unit and a single german resident of coblenz. the information has been brought to me that nora jamison, one of our own nurses, has been making friends with a group of german children. they meet her and the little french girl, louisa, in one of the city parks every afternoon and there they play together. of course, this appears innocent, but knowing the children in a too friendly fashion may mean knowing their families later. the army officers tell me there has been this same problem among our soldiers. no one seems to have been able to prevent their getting on intimate terms with every little hans and gretel who makes their acquaintance. but i do wish you would protest mildly to miss jamison. it is true that we know little of her history except that her credentials must have been satisfactory to the red cross. i confess i agreed to have her form a part of our red cross unit rather on an impulse, when i learned barbara thornton was forced to return home. besides, miss jamison herself attracted me. she has some unusual characteristic which i cannot exactly explain, but which nevertheless--" "ah, well, you need not try to explain it, david, because the thing is 'charm,' which i believe no one has successfully explained so far," sonya answered. "i presume this same charm is what endears her to the german children; it has kept the little french louisa close beside her since we left france. the little girl is getting all right too, talking and behaving like a normal person. but of course i'll ask miss jamison to be careful that her friendship with the german children does not lead to any intimacy in their homes. she told me that she was a kind of pied piper of hamlin. do you remember how the pied piper led the german children away into some undiscovered country when their parents refused to pay him his just dues? but i think the girl is peter pan instead and has some childish quality which we cannot understand but which children recognize and love in her. you see the young soldier to whom she was engaged was killed in the fighting near château-thierry and apparently children are her one consolation. she is friendly with all our red cross unit, but not intimate with one of us." when sonya and her husband finally reached the red cross headquarters, already the large building was lighted, as the darkness fell early in the winter afternoons. going unannounced into the big reception room they found it fairly crowded. the room must have been fifty feet in length and nearly equally wide and extended from the front of the building to the rear. in one end was a giant christmas tree, left over from the christmas celebration for the soldiers which in honor of new year's eve was again lighted with a hundred white candles according to a german custom. there were few other lights in the room. up against the walls were double rows of chairs in which a number of persons were seated. others were dancing in the centre of the floor. immediately mrs. arthur adams, who was in charge of the red cross headquarters, came forward to speak to dr. and mrs. clark. she was accompanied by major james hersey, who had entirely recovered from his attack of influenza and was now in command of his battalion in coblenz. a little later, after they had secured chairs, bianca zoli and dr. raymond joined them. nona davis was dancing with sergeant donald hackett, thea thompson with carlo navara. sonya noticed no one else at the moment whom she knew particularly well. yes, there standing up against the wall was nora jamison, with the little french girl's hand in hers and a line of children on either side. nona davis changing partners, sergeant donald hackett went over evidently to ask nora jamison to dance with him, but she must have declined as he continued standing beside her, laughing and talking. "have you been dancing, bianca?" sonya inquired. "you usually enjoy it so much." leaning over, bianca whispered. "please don't discuss the question aloud, sonya. no one has asked me recently, only major hersey and dr. raymond earlier in the afternoon. dr. raymond dances abominably." "not carlo?" sonya demanded. and bianca shook her head. something of their whispered conversation hugh raymond must have guessed. "we are not to have any more of the ordinary dancing just at present, mrs. clark. miss thompson and carlo navara are to do a folk dance together." just as he was speaking, suddenly the music ceased and the dancers crowded into places along the wall. a few moments later, standing in the centre of the floor and alone, were thea thompson and carlo navara. this afternoon thea did not look plain; she had on a simple black dress of some thin material, a bright sash and black slippers and stockings. her red hair formed a brilliant spot of color. carlo was in uniform. their dance was probably an irish folk dance, although it was comparatively simple yet the effect was charming. sonya believed she had never seen two more graceful persons than thea and carlo as they advanced toward each other and receded, later forming an arch with their hands above their heads and circling slowly in and out. sonya had known nothing of carlo as more than an ordinary dancer, but evidently he and thea must have been practicing together for the afternoon's entertainment. naturally, carlo's musical gifts would make him a more successful dancer than anyone without a sense of rhythm and time. in any case the effect was charming and the applause at the close enthusiastic. as soon as the dance was ended, carlo came directly over to where sonya and her husband were seated. bianca and dr. raymond were standing close beside them. "carlo, you have not asked bianca to dance, you won't forget, will you?" sonya murmured as soon as she had the opportunity without being overheard. "i am afraid you have hurt her, but please don't let her guess i have spoken to you." carlo flushed slightly. "i am sorry my dear lady," he returned, which had been one of his old time titles for sonya. "i am afraid i have neglected bianca. miss thompson is such a wonderful dancer, she is apt to make one forget any other partner." but although sonya smiled upon carlo and forgave him, declining the honor of dancing herself, bianca was not to be appeased. "i suppose sonya asked you to invite me to dance, since you waited until she arrived before you thought of me. thank you just the same but i'd rather not," bianca said later in answer to his invitation. afterwards, although carlo pleaded for her favor and returned several times with a fresh request, nevertheless bianca continued firm. then, a few moments before going back to the hospital with sonya and dr. clark, she waltzed for a short time with dr. raymond, in spite of the fact that she had been right in declaring that he was a conspicuously poor dancer. chapter xiii _a walk along the river bank_ some time later bianca and carlo navara, not having seen each other alone since new year's eve, left the hospital early in the afternoon for a walk together. as a matter of fact carlo's conscience had not been altogether easy concerning his neglect of bianca since their days together at château-thierry. and certainly before those days he had reason to be grateful to bianca and fond of her as well! moreover, a little private talk with sonya on this same subject, when sonya had not spared his vanity, had quickened his resolution. curious, sonya had said, that the artist so seldom considers loyalty an essential trait of his own character when he demands so much loyalty from others! and yet one knows that without loyalty no human character has any real value! yet carlo was not thinking of these ideas in detail when he and bianca started out. it was a february day with the faintest suggestion of spring in the damp, cold air. nevertheless, bianca herself had chosen that they walk along the river bank, following a path until they reached the promenade which extended along a portion of the rhine at coblenz like the famous board walk of atlantic city. holding tight to carlo's hand, they slipped down the hill from behind the hospital until reaching this path. but once on fairly level ground, bianca deliberately removed her hand from her companion's and began walking sedately beside him several feet away. "why not walk as we have many times with my hand in your's to keep you from slipping, bianca?" carlo inquired with a teasing inflection in his voice and manner. "i thought you and i were kind of brother and sister. i don't want you sliding off into the water." as bianca made no answer, carlo turned from her to look out over the river. today the water was dark and muddy with a strong current flowing. "bianca," carlo asked, "have you ever read the story of the rheingold in the ring of the nibelung? one has had a horror of germany for so long that one has preferred to forget german music. yet since we arrived in germany i have been reading the legends of the rheingold and they seem to me to predict germany's overthrow because of her materialism. "since to me gold is the only god, and gold alone the idol that i worship, from all worlds will i drive out all love and loving-kindness that to all other men there be no other god but gold, and gold alone shall all men serve." carlo sang these few lines softly, forgetting his companion for the moment. then he added half talking to her and half thinking aloud. "i wonder if some day, i, the son of italian parents, shall ever sing german music, if my hatred of germany and antagonism to everything else that is german will allow me even to be willing to sing it. and yet i suppose there is no great tenor who has not at some time in his life longed to take the part of siegfried, 'the curse can touch him not for he is pure, love shineth on him and he knows not fear.'" carlo ceased speaking at last and in response bianca gave a little sigh and then murmured. "i wonder, carlo, if you will ever learn to think or talk of any one except yourself?" bianca's reply was so unexpected that carlo started and then stared at her, aggrieved and slightly irritated. "but, bianca, i thought that we were such intimate friends that i could talk to you about myself, and certainly of my musical ambitions. i am sorry my vanity has bored you." the young girl shook her head. "all persons possessed of any genius are supposed to be vain, aren't they, carlo? i have known no other than you. but as for our being intimate friends, why, i do not feel that we are intimate friends any longer. after all, carlo, i cannot give all the affection and it seems to me that is what you expect. when we first knew each other and i wanted to help you because i understood that you cared for sonya in a way which she could not return, and afterwards when you were wounded and i tried to find you in château-thierry, i did not think or care, besides sonya was sonya! but now things are different." for a few seconds carlo studied the little cold, pure profile of the girl beside him. one had a habit of forgetting that bianca was approaching eighteen, and then suddenly in some unexpected fashion she reminded you that she was by no means a child. "i suppose you are referring to my friendship with miss thompson since our arrival in coblenz, bianca, or if not to our friendship at least to the fact that we have been dancing together nearly every afternoon when we both have leave. can't you understand, bianca, that it is sometimes pretty dull for one here in coblenz now the excitement and thrill of the struggle for the allied victory is past? and now and then it seems to me i can scarcely endure waiting to return to the united states and begin to work again on my music. and yet one must prove as good a soldier at one time as another. yet what is the harm in my amusing myself? i have thought sonya also appeared disapproving of late. miss thompson is not only an extraordinary dancer, but she is most agreeable and----" at this instant, having come to the end of the muddy path, carlo and bianca had reached the wide board walk which extended for some distance along the river. this afternoon it was as crowded with people as if coblenz were enjoying a holiday instead of being a city occupied by a conquering army. observing his commanding officer, major james hersey, approaching, accompanied by sergeant donald hackett, carlo saluted and stood at attention. when they had gone past he turned once more to bianca, his slight attack of bad temper having vanished. "not jealous, are you, bee? you must realize that whatever friendships i may make, i shall always be fond of you." if carlo had been noticing his companion at this moment, he would have seen that bianca flushed warmly at his condescension, and that she was extremely angry, and few people ever saw bianca angry, not perhaps because she did not feel the emotion of anger, but because she possessed a rather remarkable self control. "i don't think we will discuss the question of my being jealous, carlo, you have scarcely the right to believe that i care for you enough for any such absurdity. i don't like miss thompson very much and neither does sonya. oh, there is no real reason for disliking her! but if you are under the impression that she likes you specially, carlo, i think you are mistaken. she just likes to amuse herself too, and of course there is no harm in it." bianca's speech sounded perfectly childlike and yet perhaps she had a good deal of instinctive cleverness. in any case carlo felt annoyed. "but suppose we don't talk personalities any more, carlo," bianca apologized almost immediately. "naturally we can't always like the same people. i have never been able to get over my disappointment because the countess charlotta was not allowed to come with us to coblenz. sonya and i have nearly quarreled about her half a dozen times. and i suppose it is not alone that i am sorry for the countess charlotta, but because i do need a girl friend so dreadfully, carlo. it seems strange doesn't it, and i am almost ashamed to speak of it, but i have never had a really intimate girl friend in my life. i suppose this may be partly due to the queer circumstances of my life. you see with my father dead and my mother an italian peasant, who wished to make my life so different from her own that i was not allowed to associate even with her very closely, and then being brought up by a foster mother who did not encourage other girls to make friends with me, because she might have to tell them of my peculiar history, i suppose i did not have much of a chance for friendships with the kind of girls i would like to have known! then i realize that i have not a very attractive disposition." bianca's little unconscious confession of loneliness had its instantaneous effect upon her companion. "don't be a goose, bianca mia," carlo answered, using an italian phrase which he sometimes employed, recalling the bond of their first meeting in italy several years before. "but who is this countess charlotta whom you desire to have with you here in coblenz in order that you may continue your friendship?" just an instant bianca appeared troubled and then her expression cleared. "perhaps i should not have spoken of the countess charlotta, not even to you, carlo, only of course i know i can trust you. she was a young girl who was ill in our temporary hospital in luxemburg. i thought of course she would write me, as she promised to write when we said goodby. but i have never had a line from her and neither has sonya although sonya and i have both written her since our arrival in coblenz. i am afraid something must have occurred to prevent her writing and so i have been uneasy." bianca's speech was not especially clear, nevertheless carlo listened sympathetically and asked no embarrassing questions. a little time after they entered the famous coblenzhof where bianca had been invited to have tea. it was crowded with people and looked like sherry's on a saturday afternoon. both carlo and bianca gazed around them in amazement. the people were all comfortably, some of them almost handsomely dressed, even if with little taste, but this was usual in germany. they were drinking coffee and eating little oatmeal cakes and appeared contented and serene, even without their famous "deutsche kuchen." "i sometimes wonder, carlo," bianca whispered, when they were seated at a small table in a corner, "if some of these people are not glad after all that the kaiser has been defeated and that they are to have a new form of government and more personal freedom? they certainly seem to be glad the fighting is over. i suppose they had grown deadly tired of it and of being deceived by their leaders." carlo shook his head warningly. "be careful, bianca. in spite of what you think there are still thousands of people in coblenz faithful both to the kaiser and his principles. some of them may seem friendly to us, but the greater number are sullen and suspicious, regardless of the order that they are to appear as friendly as possible to our american troops. yet somehow one can't help feeling as if there were plots against us of which we know nothing, just as there was in every allied country before the beginning of the war." carlo smiled. "here i am saying the very character of thing i asked you not to speak of, bianca! by the way, do you suppose we know any people here? let us look around and see." chapter xiv _major james hersey_ arrangements had been made in coblenz for the quartering of the officers of the american army of occupation in certain german homes, payment being made in an ordinary business fashion. on arriving in coblenz, after his illness in luxemburg, major jimmie hersey discovered that especially comfortable accommodations had been prepared for him. also he was to have as his companion, a personal friend, sergeant donald hackett an exception being made to the sergeant's living in the same house with his commanding officer. the household in which the two young americans were located was one of the many households at this time in germany whose state of mind it would have been difficult for any outsider to have understood or explained. the head of the family, colonel otto liedermann, was an old man, now past seventy, who had once been a member of the kaiser's own guard. his son, captain ludwig liedermann had been seriously wounded six months before the close of the war, and, although at present in his own home, was still said to be too ill to leave his apartment. there was one grown daughter, hedwig, who must have been a little over twenty years of age. the second wife, frau liedermann, was much younger than her husband, and her children were two charming little girls, freia and gretchen, who were but six and eight years old. outwardly the german family was apparently hospitably disposed to their enemy guests, although they made no pretence of too great friendliness. they saw that the americans were cared for, that their food was well cooked and served. yet only the two little girls, freia and gretchen, possessed of no bitter memories, were disposed to be really friendly. and in boyish, american fashion, the two young officers, who were slightly embarrassed by living among a family with whom they had so lately been at war, returned the attitude of admiration and cordiality of the little german maids. freia was a slender, grave little girl with sunshiny hair and large, soft blue eyes, and gretchen like her, only smaller and stouter with two little yellow pigtails, and dimples, in her pink cheeks. one afternoon major jimmie hersey was sitting alone in a small parlor devoted to his private use and staring at a picture on the mantel. his work for the day was over, the drill hour was past and the soldiers, save those on special leave, had returned to their barracks. one could scarcely have said that the young american officer was homesick, for there is something really more desolate than this misfortune. he was without a home anywhere in the world for which he could be lonely. an only son, his mother had died when he had been six months in france. it was true that he had a sister to whom he was warmly attached, but she had married since her brother's departure for europe, and for this reason he did not feel as if she belonged to him in the old fashion of the past. at the moment he was looking at his mother's photograph and thinking of their happy times together when he was a boy. in spite of his present youthful appearance major james hersey regarded himself as extremely elderly, what with the experiences of the past years of war in france and his own personal loss, and the fact that he was approaching twenty-five. then from thinking of his mother, jimmie, whose title never concerned him save when he was commanding his men, suddenly bethought himself of the young countess charlotta. it was odd how often he recalled a mental picture of her, when they had met but once. he had seen her again, however, on the morning when she had left the hospital at luxemburg. then he had watched from a window the carriage which drove her away. somehow the young countess charlotta in spite of her different surroundings, had struck him as being as lonely as he was. then major jimmie smiled, realizing that he was growing sentimental. yet the girl's story had been a romantic one and she had confided in him so frankly. after all, one does enjoy being sorry for oneself now and then! the young officer at this instant was disturbed in his meditations by hearing a little sound beside him. glancing around he beheld gretchen, the youngest daughter of the german house. this was the first time since his arrival in her home that he had ever seen the small girl without freia, her two years older and wiser sister. plainly enough by her expression gretchen showed that she resented this misfortune. there were tears in her large light eyes and her little button of a nose was noticeably pink. "what is it, baby?" the young officer demanded, his sympathy immediately aroused and glad also to be diverted from his own train of thought. "it is that freia has been allowed to go to play this afternoon with the lady from the red cross and the little french girl and that i must stay at home," the little girl lamented, speaking in german that her listener could readily understand. major hersey had studied german at school as a boy and during the last few weeks of residence in germany had been surprised by recalling more of his german vocabulary than he had dreamed of knowing. "freia would like to bring fraulein jamisen home with her only she will not come." gretchen sighed, although beginning already to feel more comfortable. it was warmer in her major's room than in any portion of their large house; a small wood fire was burning in his grate. the little girl grew disposed toward further confidences. "people come to our home all the time to see my brother, but freia and i are never allowed in the room, only my father. then they whisper together so we may not hear." major hersey smiled; gretchen was a born gossip, even in her babyhood, already he had observed that she deeply enjoyed recounting the histories of her family and friends, more especially what gretchen unconsciously must have regarded as their weaknesses. "but your brother, captain liedermann, is ill, perhaps it is natural that he does not wish a little chatterbox about him all the time. if i had been confined to my bed for as many months as he has, why i should have turned into a great bear. one day you would have come in to speak to me, gretchen, and then you would have heard a low growl and two arms would have gone around you and hugged you like this," and major hersey suited his action to his words. after a little squeak half of delight and half of fear, gretchen settled herself more comfortably in her companion's lap. however, she was not to be deterred from continuing her own line of conversation. in the years to come, major jimmie had a vision of this same little german girl, grown older and stouter, her yellow pigtails bound round her wide head, sitting beside just such a fireside as his own and talking on and on of her own little interests and concerns, forever contented if her hearer would only pretend to listen. for the sake of the listener of the future jimmie hoped that the small gretchen would continue to have the same soothing effect that she was at present producing upon him. "my brother is not always in bed," gretchen protested. "now and then when he thinks he is alone, and i am only peeping in at the door, he climbs out of bed and walks about his room. one day one of his friends was in the room with him and when he got up and stamped about they both laughed." "oh, well, any fellow would laugh if he was growing strong again after a long illness," major hersey answered a little sleepily, realizing that gretchen really required no comment on his part. "besides, you must be mistaken, your mother told me that captain liedermann had not been so well of late, nothing serious, a little infection in a wound he had believed healed. as for guests who come frequently to your brother's room, why i never knew so quiet a household as your's, _kleines madchen_! during the many hours i am here in this sitting-room, no one ever rings the front door bell or passes my door." as a matter of fact major hersey's sitting-room was upon the first floor of the house and near its entrance. formerly his room must have been either a small study or reception room, as the large drawing-rooms were across the hall. but these were never in use at the present time and kept always darkened, as a household symbol that all gayety and pleasure had vanished from the homes of germany. it occurred to jimmie hersey at this instant to wonder if hedwig liedermann had no friends. she was a handsome girl with light brown hair and eyes and a gentle manner. surely there must be some young german officer in coblenz who regarded her with favor! but if this were true he had never appeared at her home at any hour when major hersey had caught sight of him. it would not be difficult to recognize a german officer, even if he should be wearing civilian clothes. besides why did fraulein liedermann not entertain her girl friends in the drawing-rooms of her home? these rooms must have been used for social purposes before the war, as the position of colonel liedermann's family in coblenz was of almost equal importance with the german nobility. "oh, no one comes to call upon us at the front door any longer," gretchen added amiably. "you see you are an american officer and use this door and our friends do not wish to see you. they do not seem to like you." "they--they don't," major hersey thought other things to himself, although naturally, in view of his audience, saying nothing unpleasant aloud. how stupid he was not to have guessed what the smallest daughter of the house had just related! after all one could understand, the german viewpoint since in spite of having been told to love our enemies, how few of us have accomplished it? it could not be agreeable to the defeated officers and soldiers of the conquered german army to enter the homes of their friends and find them occupied by the victors. "better run away now, gretchen, it must be getting near your tea-time," the american officer suggested, the little girl having occasioned an unpleasant train of thought by her final chatter. but before gretchen, who was not disposed to hurry, had departed, they were both startled by the sudden ringing of the front door bell, the bell whose silence they had been discussing, then they heard the noise of people outside. a little later, one of the maids having opened the door, gretchen and major hersey recognized familiar voices in the hall. the same instant gretchen escaped. then followed a cry from frau liedermann, and sergeant hackett's voice and another voice replying. major hersey, unable to guess what had taken place, and anxious, joined the little group outside his door. in his arms sergeant hackett was carrying freia. it was apparent that the little girl must have fallen and hurt herself, yet evidently her injury was not serious. they were accompanied by nora jamison and the little french girl, louisa. "i am so sorry, frau liedermann, a number of children were playing in the park and freia must have fallen among some stones. she was so frightened i thought it best to come home with her and we had the good fortune to meet sergeant hackett along the way. i don't think you will find there is anything serious the matter; i am sorry if we have alarmed you. i must return now to the hospital." at this moment unexpectedly frau liedermann began to weep. she was a little like a grown-up gretchen, and one felt instinctively that she was out of place in her husband's household. he was a stern and gloomy old man, possibly too proud to reveal to strangers how bitterly angered he was by the german defeat and the disgrace of his former emperor. but freia, whose name came to her from the legendary german goddess, who represented "life and light and laughter and love," was the adored child of the family and particularly of the little mother to whom she was "her wonder child." "but you will stay and see if freia is seriously hurt? you are a red cross nurse and must know better than i," frau liedermann pleaded. "freia has so often said that she wished to have us meet, but you would not come to our home and i could not go to you at your american red cross hospital. can the war not be over among us women at least? i have relatives, brothers and sisters in america from whom i have not heard in four years. yet my husband thinks i am not a true german because i wish to be happy and make friends again with our former foes." just for a fraction of a second nora jamison's eyelids were lowered and her face changed color. was it possible that she did not desire to forgive and forget as the little german frau appeared to wish? was there not a grave near château-thierry and a memory which must forever divide them? and yet of course one did not wish to be unkind. "please stay just a minute," freia pleaded. the following moment major hersey watched the little procession climbing the stairs to the second floor of the house where the family were living at present. first frau liedermann led the way, then freia walking, but holding close to miss jamison's hand, gretchen and louisa just behind them. afterwards major hersey was glad to have been a witness to this first introduction of nora jamison, into the german household. chapter xv _a re-entrance_ on this same evening major hersey and sergeant hackett were sitting before the same fire, shortly after dinner. they were talking in an idle fashion, neither of them particularly interested. both would be pleased when the evening was over and they were in bed. major hersey had given his orders to his sergeant for the following day and then had suggested that he sit with him for a time longer. the days were not difficult in coblenz where one had many duties and interests, besides the association with one's fellow soldiers and a few other friends. but unless one went constantly to the german restaurants and theatres and movies, one could not find sufficient entertainment in the various y. m. c. a. and red cross headquarters to occupy every evening of the week. it was a brilliant winter night and the young men had left the curtains of the window open and the blinds unclosed so that the early moonlight shone into the room. therefore both of them noticed a soldier-messenger march down the street from the corner and enter the front yard of the house where they were living. in answer to a command from his superior officer, sergeant hackett met the messenger at the front door. the soldier bore a note which was addressed to major hersey. the note requested that major hersey come at once to the headquarters of his colonel. there was no explanation as to why his presence had become suddenly necessary. however, without any particular emotion either of interest or curiosity, major hersey at once set out. the streets were fairly deserted. the citizens of coblenz were living under military law and, although the laws were not severe, two demands were made upon them, one that no arms or ammunition of any kind remain in the possession of any german, the second that they be inside their own homes at a certain hour each night. this hour had not arrived and yet there were not many persons about, a few groups of american soldiers on leave, but scarcely any germans. the house of colonel winfield was at no great distance away. "most extraordinary thing, hersey!" the colonel was soon explaining, "you might guess for a dozen years why i have sent for you and never hit the correct answer. don't look so mystified over my words. i have not sent for you to give you any military command, or to ask your advice on military matters, as i have now and then in spite of your being too youthful for the title you have been lucky enough to earn. i have sent for you because tonight you and i may regard ourselves as characters in a play. in a short time i hope to introduce the heroine." colonel winfield was an elderly man a good deal past fifty, with closely cropped grey hair, small twinkling blue eyes under heavy brows and a mouth which could be extremely stern when the occasion demanded and equally humorous under opposite conditions. tonight he was seated in a large, handsome room, a little too elaborately furnished after german ideas of luxury, and before a wide table covered with books and old american newspapers and magazines. major hersey could only stare at him in amazement, and with a total lack of comprehension. "i might as well explain to you your part in the drama, hersey. you haven't at present a very fortunate role, although i cannot tell how it may develop. the facts are that two women, or i should say one woman and a girl, arrived in coblenz this afternoon without satisfactory passports. they were detained by one of our officers and because of something or other in their story, perhaps because of their appearance and manner, the circumstances were reported to me. i believe the young woman knew my name and requested that she be allowed to speak to me. i was busy and only saw her and her companion a few moments ago. then she asked that i send for you and for mrs. david clark, saying you would both be able to identify her. most extraordinary story she related, i find it difficult either to believe or disbelieve!" and colonel winfield leaned back in his chair studying the younger officer's face. if he expected to find any clue to his puzzle in major jimmie's expression at this instant he was disappointed. the younger man was nonplused. a woman and a girl who had arrived in coblenz insisting that he could identify them! why, he knew no woman or girl in the world who would be apt to make so unexpected an appearance! and yet for a few seconds the names of several girls he had known in the united states in the past who might possibly have come to coblenz to work among the soldiers flashed before his mental vision. "suppose you see the two strangers at once, jimmie, i don't feel that i have been polite in forcing them to wait here for me as long as they have waited, but i was unavoidably detained. they are in a little reception room across the way. i'll ask them to come here and speak to you as this room is larger and more agreeable." "don't you think, colonel, we might postpone the interview until the arrival of mrs. david clark? surely the women would find it more agreeable to explain their situation to her," major hersey protested. the older man shook his head. "i have sent for mrs. clark, but remember she is living at some distance from here and may not be able to come to us tonight. in a moment it will all be over, james. if you do not know the young woman who says she knows you, you have only to say so briefly. i have an idea, however, that almost any young man might wish to know her. yet if there is any uncertainty about her story, we must see that she and her companion are made comfortable for the night somewhere and then that she starts for home in the morning. i have an idea from what she confided to me that she must be sent home in any case." a few moments later, colonel winfield re-entered the library with two companions. one of them was a thin, angular woman with a large nose and a highly colored skin. she was wearing a black dress and coat and a black feather boa. the other was a girl of about twenty in an odd costume. a portion of it was an american red cross uniform, worn and shabby, a dark blue coat and cap with the red cross insignia. the girl's skirt was of some other dark cloth, yet on her arm she carried a splendid sable coat. underneath her cap her cheeks were brilliantly red and her eyes glowing. "countess charlotta!" major hersey stammered. "what brings you to coblenz? you have relatives here whom you are intending to visit?" the girl turned toward the older american officer. "there! major hersey does remember me and i was so afraid he might have forgotten! we met but once in the red cross hospital in luxemburg where we were both patients at the same time. at least until mrs. clark arrives he may persuade you, colonel winfield, that i am not a spy or in any way a dangerous character." then the girl turned again to major jimmie. "i don't know what mrs. clark will say or do when she sees me. she told me positively i was not to embarrass the american red cross by taking refuge with them. and i tried my best to be brave and endure my existence. i even gave up to my father's wishes, but i found i could not keep my word. so i confided in miss pringle. she is english and was my governess when i was a little girl. she had continued living in luxemburg after the war began, and yet perhaps because she was english she understood me better than other people. anyhow we came away together. it was not so difficult to accomplish as you may imagine. most of the people in luxemburg at present dislike the germans as thoroughly as i do. i told a few acquaintances that i was going away because i could not endure being forced into a german marriage. miss pringle was with me and i said i was going to join some american friends. besides, luxemburg is not very large you know and it does not take long to reach the frontier. if mrs. clark is not willing to receive us at the red cross hospital, surely we can find a place to shelter us for awhile. miss pringle says she will be glad to go with me to the united states, as she has long wished to travel. i suppose, colonel winfield, that you could arrange for us to go to the united states?" plainly the young countess's words and manner both amused and annoyed the colonel. "nonsense, young woman, girls who run away from their homes no matter from what motive, must be sent back to their parents. mrs. clark will doubtless see that you and miss pringle are made comfortable for a few days. but i think i understand how you managed to reach coblenz and why you were permitted to have an interview with me. the colonel of an american regiment of the army of occupation is not in the habit of having young women whose credentials and passports are not what they should be, take up his spare time. where, child, had you ever heard my name?" "oh, i often heard mrs. clark and the american red cross nurses speak of you when they referred to their winter at the red cross hospital near château-thierry. they said too they were delighted that you were to be in coblenz because they liked you so very much," the countess charlotta concluded in the frank fashion which was entirely natural to her. nevertheless the colonel looked slightly mollified. "you will sit down, won't you, and wait until we hear whether mrs. clark will be able to join us tonight?" the colonel pushed a large leather chair toward the fire, which the little countess dropped into gratefully. miss pringle was already seated in a chair which major hersey had provided for her during the countess charlotta's recital. "i am sorry, extremely sorry, you were forced to wait so long to see me," colonel winfield protested. "it would have been pleasanter if arrangements could have been made for you earlier in the day." "oh, you need not worry," the countess charlotta returned graciously, "i am not in the least unhappy myself. getting away from luxemburg was so much simpler than i ever dreamed it could be, that nothing ahead seems so important. i wrote my father saying that i intended to sail for the united states as soon as it could be arranged. as for sending me back home," the little countess stretched her two hands before the fire so that they grew rose pink from the warmth, then she sighed, but with no deep show of emotion, "it would be very useless and very unkind to send me back to my father after what i have done? neither my father nor aunt will wish to see me again. even though they know miss pringle has been with me every minute and that i have done nothing in the least wrong, they would never forgive my disobedience. and they would not wish me to live with them because they should always consider that i had disobeyed them and that i would be an unfortunate influence upon other girls in luxemburg." at this instant there was a knock at the door and a few moments later sonya, dr. clark and bianca entered the large room. if there was no especial enthusiasm in sonya's greeting of the countess charlotta, still there was no question of their acquaintance and bianca's welcome revealed all the pleasure which sonya's lacked. nevertheless, sonya offered to take charge of miss pringle and the young countess at the red cross hospital for the night until better arrangements could be made. they had several spare rooms in the old castle. it was too late at present for any definite point of view in regard to the unexpected intruders. chapter xvi _a growing friendship_ a few weeks passed and it was march in coblenz. the days continued cold and oftentimes dreary, but the american army of occupation was growing more accustomed and more reconciled to their new way of life. then there were occasional spring days when the winds blew from the south bringing with them scents and fragrances of gentler lands. at the american red cross hospital high up on the hill overlooking the rhine the conditions were reflected from the army. the red cross staff also became more contented and more amenable to discipline than in the early weeks succeeding the close of the war. there were a good many patients constantly being cared for at the hospital, but they were simply suffering from ordinary illnesses. only now and then a wounded american prisoner, only partially recovered, would come wandering in from some german hospital in the interior, preferring to be looked after by his own people until he was well enough to be sent back home. therefore, although there was sufficient work for the entire corps of physicians, nurses and helpers, there was no undue strain. however, one member of dr. clark's former staff was freed from all red cross responsibility. even before her arrival in coblenz, bianca zoli had showed the effects of the nervous strain of the last months of her war work. moreover, sonya had always considered that bianca was too young and too frail for what she had undertaken and had wished to leave the young girl at school in new york until her own and her husband's return from europe. but as bianca had been so determined and as sonya had dreaded leaving her alone in the united states, she had finally reluctantly consented. and bianca had done her full duty. never once in the terrible months before the close of the war had she flinched or asked to be spared in any possible way. nor was it by bianca's own request that she was idle at the present time. it was sonya who first had noticed the young girl's listlessness, her occasional hours of exhaustion and sometimes of depression. and it was sonya who had called her husband's attention to bianca's condition, although afterwards it was dr. clark who had ordered that bianca have a complete rest. during the first weeks in coblenz, bianca had been bored and sometimes a little rebellious over this new state of her existence. she had no friends of her own age in coblenz, the red cross nurses at the hospital were too much engaged with their work and in their leisure with other interests in which bianca had no share, to give her a great deal either of their time or thought. sonya naturally wished to be with her husband whenever it was possible, although she never for a moment neglected, or failed to look after bianca's health and happiness in every fashion she could arrange. but what bianca really needed was entertainment and friendships near her own age and these under the present circumstances of their life, sonya was not able to provide. so far as bianca was concerned, carlo navara had really ceased to count in any measure of importance. he so seldom made the effort to see bianca and appeared wholly absorbed by his soldier life and such entertainment as he found outside. from his superior officer he had secured permission to take singing lessons from an old music master in coblenz, and was finding an immense satisfaction and help in this. but with the coming of the young countess charlotta to coblenz, life assumed a new and far more agreeable aspect for bianca. charlotta had spoken with the wisdom of a knowledge of human nature in announcing that neither her father nor aunt would desire her return to luxemburg once they learned of her act of rebellion. immediately after her unexpected arrival, sonya clark had written to the count scherin advising him of charlotta's action, saying that she was entirely well and carefully chaperoned by miss pringle. but sonya also inquired what the count scherin's wishes might be concerning his daughter. in reply she had received a tart letter from the count stating that in future charlotta might do what she liked, as it was apparent that she had no idea of doing anything else. in a comparatively short time she would reach the age of twenty-one and would then inherit an estate from her mother, but until then count scherin would arrange that charlotta should receive a modest sum of money each month sufficient for her own expenses and that of her governess. it was true that the elderly man also added that he would be grateful to mrs. clark if she consent to become his daughter's friend, although from his own experience he could promise but little appreciation from charlotta in return. upon receipt of this letter sonya had showed it to the young girl and charlotta had made no comment. a day or so later, she suggested that she and miss pringle remain for a time in coblenz boarding as near as possible to the american red cross if this were in accord with mrs. clark's judgment. and since sonya had no better suggestion to offer at the time, after a few days' stay at the red cross hospital, the young luxemburg countess and her former governess found a home with a quiet german family, who, impoverished by the war, were glad to receive them. the house was not half a mile from the hospital, and so far as bianca was concerned, sonya was glad the young countess had chosen to stay for a time in their neighborhood under a kind of imposed chaperonage on her part. she had not desired to have charlotta added to her responsibilities. but the young girl apparently was anxious to be as little trouble and to incite as little censure as possible after her one act of self-assertion. sonya could not blame her altogether, although disapproving of charlotta's method of retaining her freedom. moreover, the young countess seemed to possess many of the characteristics which might be a good influence for bianca, perhaps because of their very contrast. if charlotta was too frank in her attitude to strangers and her habit of taking them immediately into her confidence, bianca was altogether too reserved. if the one girl was a little too curious and too much interested in the histories of every human being with whom she came in contact, bianca was too little interested in them. moreover, charlotta, in spite of her occasional moments of depression was naturally gay and sweet tempered, while bianca had a little streak of melancholy, sometimes of hidden obstinacy due to her strange childhood. but best of all in its present effect upon bianca, in sonya clark's opinion, was charlotta's love of the outdoors. fresh air, exercise and cheerfulness were the only medicines dr. clark had considered bianca required. never in her life had bianca been out of doors as much as was good for her, her childhood in italy having been spent largely among older people. moreover, her peasant mother had considered that bianca must be sheltered and nurtured like a hot-house flower in order to preserve the little girl's shell-like beauty and to make her as little like other children as possible. now with charlotta's companionship she and bianca spent the greater part of each day outdoors, sometimes accompanied by miss pringle, who as an englishwoman was an indefatigable walker. but now and then the two girls were alone. this was scarcely a satisfactory arrangement since coblenz was filled with soldiers and sonya was by no means content. she could only insist that the two girls be extremely careful and never go any distance by themselves, and also that charlotta remember that as bianca was not well, they must never undertake any excursion which would demand too much of bianca's strength. at first sonya was surprised by charlotta's consideration of the younger girl, it having been reasonable to presume from their brief acquaintance that charlotta was selfish and self-willed. yet she seemed really devoted to bianca and more than willing to sacrifice her own wishes for her friend. it was one afternoon in the latter part of march soon after luncheon that miss pringle, charlotta and bianca started out together for an afternoon walk. the day was the warmest day of the early spring and they decided to walk away from the city toward a woods which was probably only about a mile and a half from the neighborhood of the red cross hospital. nevertheless, it was cold enough for bianca to be wearing the simple grey squirrel coat which sonya had presented to her some time before, while charlotta wore the sable coat which was too handsome for her present position and needs. but miss pringle was attired in her usual shabby black dress and the everlasting black feather boa. the two girls talked continuously so that miss pringle rarely paid any especial attention to what they were saying. she was extremely fond of the countess charlotta, but the young girl's enthusiasms sometimes tired her. moreover, miss pringle was honestly fond of the country as only a few persons are and able to amuse herself indefinitely by studying the surrounding scenery. this afternoon bianca and charlotta walked arm in arm along a road leading toward the woods beyond, miss pringle walking sedately about a foot behind her two charges. the road was hard and dry as there was a high march wind, although not at present a cold one. "are you sure you will not become tired, bianca, and the distance is not too much for you?" charlotta inquired, when they had gone about two-thirds of the way toward the woods. smiling, bianca shook her head. "don't be tiresome, charlotta. i am feeling better since you came to coblenz than i ever remember before, and not only physically better but so much happier." bianca flushed a little since it was difficult for her to make even this revelation of her emotions. it was true, however, that since charlotta's arrival she had found the girl friend she so greatly needed. indeed, charlotta had made her almost forget the little soreness which carlo navara's failure to return her friendship had left in her. a few moments later charlotta stopped and turned around. "we are not walking faster than you like, miss pringle?" she inquired. then she added unexpectedly. "dear susan pringle, you are nearly frozen. why look, bianca, her lips and cheeks are blue! what on earth made you come for a walk without any warmer clothes? it is that old english prejudice which makes you think heavy garments are never necessary. you must go back home at once. you are positively shivering." and it was true that as the two girls and the older woman stood together in a little group for a moment, miss pringle could scarcely keep her teeth from chattering. "i am just a little cold," she confessed, "however, girls, i do not wish to rob you of your walk." charlotta smiled back at her serenely. "oh, you need not worry, susan dear! your returning home for something warmer to wear need not interfere with our plans. we will just walk on slowly toward the woods and when we reach there start back. if you do not overtake us, we will meet you on our way home." this suggestion was not wholly approved of by miss pringle and yet at the moment, being a little frozen mentally as well as physically, she made no serious objection to it. she believed she could walk home rapidly and be with the two girls again in a short time. moreover, it was one of her serious weaknesses of character that she seldom objected to any positive wish of the young countess's. in the brilliant march sunshine the path through the woods appeared like a path of gold. there were no leaves on the tall trees so that the light shone through the bare branches. "let us go on just a little further, charlotta, and then we must go back to meet miss pringle," bianca proposed. but here the path grew narrow so that charlotta led the way, bianca following at first close behind her. the air was like magic, the old magic of youth, "of love and life and light and laughter." charlotta sang along the way. "wheresoe'er the sun doth journey in his chariot, i have sought for that which shall outweigh the love of woman. on earth, in air, in water, many things fair have i found, the seed of song in man, the seed of flowers in the earth, but over all, and fairer far and greater, is the seed of love. when love hath flown, who shall endure?" "queer song for me to sing, isn't it, bianca?" charlotta called back over her shoulder. "yet perhaps after all it is because i intend to try to live always as true as i can to my ideals that i have done what my father and aunt and perhaps mrs. clark do not approve. i ought to remember that i am a good deal older than you are in years and far, far older in experience. yet i do so love the old german lieder, even if they are sentimental." as bianca made no reply to this speech continuing on her way, charlotta began walking faster than she realized. until this afternoon she had never felt so thoroughly happy over her freedom from the future which for nearly a year had stretched before her like a dark cloud. since leaving luxemburg, although she had not actually regretted her own action, at least she had been harassed with the sense of her father's anger and disappointment. but today she was happy in forgetting everything save her love of the fresh air, of the blue sky, of the dark rim of hills on the further side of the rhine, of walking deeper and deeper into the spring woods. "don't you think we had better go back, charlotta?" bianca called, not once, but several times, and if charlotta had only been less self-absorbed she must have understood that bianca's voice each time sounded a little further away and fainter. but finally, hearing an unexpected sound, charlotta swung swiftly around. about half a dozen yards from her, bianca had fallen and was making no effort to rise. "bianca dear, i am so sorry," she cried out at once with the impulsive sweetness characteristic of her. "i am afraid you are tired out and i am a wretch not to have remembered! mrs. clark will be angry with me. come, let me help you up. i wish i could carry you, but at least you can take my arm. oh dear, what an impossibly selfish person i am! poor miss pringle is probably dreadfully worried to discover what has become of us. i fear my aunt is right when she says i never think of other people until it is too late to be of value to them." but although bianca did get up, charlotta was frightened to discover that every bit of color had disappeared from her face and that she looked utterly worn out. "i was stupid not to have gone back without you, charlotta, or not to have made you understand i was too tired to walk so far," bianca protested, not willing to allow the other girl to bear all of the responsibility. "besides, it is stupid of me to be so good-for-nothing these days. i wish i had half your energy." "an energy which does nothing for other people isn't worth much as a possession, bianca," the older girl returned. "but don't try to talk, and let us walk slowly as you wish. the blame is all mine and i will bear the full burden of it on our return. i am only afraid mrs. clark will not encourage our being together again." at the edge of the woods near the place where they had entered bianca had to sit down for a little time to rest. "wait here and i will run ahead for a short distance. perhaps i may find miss pringle still searching for us, little as i deserve her kindness, or perhaps i can find some kind of vehicle, bianca. if not i will ask some one who will go back to coblenz and get a car for us. i really do not think you can manage to walk the rest of the way. don't be frightened, i won't be long." charlotta was not long. a quarter of a mile away, major james hersey, who was having his usual afternoon exercise on one of the army horses, heard his name called unexpectedly by a voice which he recognized at once. the next moment the countess charlotta had explained the situation. in a short time bianca was seated on horseback with her arms about charlotta while major hersey walked beside them into coblenz. as bianca did not know how to ride, she preferred that charlotta should ride in front. chapter xvii _faith and unfaith_ within the next weeks major jimmie hersey found himself much less lonely than during the earlier part of his stay in the occupied city of coblenz. of late a pleasant friendship had been developing between the young countess charlotta and himself. after her too lengthy walk, bianca zoli had been ill and not able to spend as much time with her new friend as she formerly had. at first charlotta had been inconsolable, blaming herself for bianca's breakdown and refusing to amuse herself in any of her accustomed ways. but with the arrival of spring it became impossible for her to remain indoors, especially as she was only permitted to see bianca for a few moments each day. it was not that dr. and mrs. clark particularly blamed charlotta, bianca being entirely responsible for her own actions. moreover, dr. clark did not believe that any one exhausting experience had been the cause of bianca's illness but an accumulating number of them, especially her presence in château-thierry under such strange conditions during one of the final battles of the war. yet it was bianca's breakdown which was the beginning of a relation approaching friendship between the young united states officer and the countess charlotta scherin. as bianca had been in a nearly fainting condition when she was brought finally to the american red cross hospital, naturally major hersey called there the next day to inquire for her. by chance, as charlotta had haunted the hospital all day, she and miss pringle were leaving the moment major hersey arrived. as his inquiry occupied only a short time, he was able to overtake the young girl and her chaperon before they had gotten any distance away. "i don't know what we should have done if you had not been riding horseback yesterday, major hersey," charlotta declared. "i don't believe bianca could possibly have walked back, or waited very long while we tried to find a vehicle. i'm afraid too that i actually enjoyed my own ride even under such circumstances. you cannot realize how much i have missed riding in these last weeks. i think until my accident, or whatever one may choose to call it, i had been on horseback every day of life from the time i was five years old. i am envious of you. do you suppose it would be possible for me to get hold of a horse in coblenz which i could use? any kind of horse will be better than none." ordinarily, jimmie hersey was shy, finding it difficult to talk to young women or girls without embarrassment. yet one could scarcely be shy with the countess charlotta, she was so frank and direct herself and so free from any affectation. "i don't know, i expect it would be hard work to find a woman's riding horse in coblenz these days. the horses that were any good were requisitioned for the german cavalry. but there is just a chance that i may be able to borrow one of our own american horses for you occasionally. i can't promise of course, but it would be jolly if you could ride with me." "i should love it," the countess charlotta answered. "but i suppose we ought to have some one else with us; it won't do under the circumstances for us to ride alone," major hersey added. during this speech the young officer colored slightly, since it was not among his usual duties to chaperon a girl. however, he knew what was fitting and intended that the conventions should be obeyed. glancing toward him, the little countess was about to demur, insisting that, although of course it might be advisable to have an escort, nevertheless, she did not wish to be deprived of opportunities to ride for such a reason. however, observing major jimmie's expression rather surprisingly she remained silent. in spite of his boyish appearance, his gentle brown eyes and sometimes almost diffident manner, there was a firmness in his mouth and chin which few persons ever misunderstood. it was during one of their afternoon rides together, about ten days later, when they were accompanied by sergeant donald hackett and nora jamison, that unexpectedly charlotta turned to her escort. "you don't approve of my having come away from home in the way that i did, do you, major hersey? oh, i know you have never said anything of course, since you do not consider that we know each other sufficiently well to discuss personalities, yet just the same you do disapprove of me." jimmie hersey shook his head. "certainly i do not disapprove of you." then he flushed and laughed. "may i say instead that i approve of you highly. you don't mind my being a little complimentary?" "oh, if you mean to be flattering me, you need not think i am not pleased. but what i meant was that you do not approve of my action. please answer me truthfully. i shall not be offended. after all, you see i am asking you the question, so you cannot be blamed for telling me the truth." still the young american officer hesitated. "well, countess charlotta, you must always remember that i am a soldier, and that in so far as possible i try to live up to a soldier's ideals. one of them is to face the music, never to run away. but there, that seems an extremely impolite thing for me to have said! you know how glad i am personally that you did come to coblenz." to the latter part of major hersey's remark, charlotta apparently paid no attention. she dropped her chin for a moment and stared straight ahead of her. this afternoon she was wearing a brown corduroy riding habit and brown leather boots and a close fitting corduroy riding hat. her father had not been so obdurate that he had not sent charlotta a large trunk of her clothes soon after he learned of her safe arrival in coblenz. "you mean to say as kindly as possible that you think i am a coward," she returned finally. "that is what mrs. clark thinks also, only she has not said so, i suppose because i have never asked her. sometimes, i have wondered since my arrival in coblenz, if i should go back home and ask my father's forgiveness, making him understand that i shall never marry any one for whom i do not care. but my problem is, would he accept an apology which did not include obedience? you see that is what my new american friends cannot understand in my father's and my attitude to each other. besides, i do so want to go to the united states when mrs. clark and bianca and several of her red cross nurses return home. mrs. clark tells me that she and dr. clark only intend remaining in coblenz until after the germans have signed the treaty of peace. dr. clark then feels that he must go back to his new york city practice and be relieved by a younger man. three or four of the american red cross nurses will be sailing at the same time. you simply cannot guess how i long to travel. think of being as restless a person as i am and shut up in a tiny country like luxemburg! i have never been anywhere else except just into germany in all my life." "hard luck of course, and you would enjoy the united states! you are just the kind of girl to appreciate it. you must do what you think is right yourself since after all another fellow's judgment is not worth much," major hersey replied, not altogether pleased with the idea of his new friends vanishing from coblenz when his own duties might keep him there an indefinite time. later that afternoon, at about dusk, on his way toward home, major james hersey was considering a number of matters somewhat seriously. he was a united states officer with nothing to live upon save his pay. up to the present his one desire had been to continue to serve his country. in germany at this time there was a good deal of intensely bitter feeling. with the delay in the presentation of the peace terms a less friendly attitude toward america and the americans was developing than during the weeks first following the german defeat. in the interior the poorer people were said to be hungry, war weary and anxious to resume their normal business life. in coblenz there was especial dissatisfaction with the present german government, coblenz having been a centre of pan-germanism and pro-kaiserism. carefully concealed as such ideas were supposed to be from the members of the american army of occupation, there were united states officers who appreciated that there were groups of prominent germans at this time desiring the return of the kaiser and some form of monarchial control. it was not known in march that the kaiser might be tried by an international court. quietly major hersey had been informed that the united states secret service was endeavoring to discover the men who had been the kaiser's closest friends in coblenz before his inglorious departure into holland. there were still, major jimmie reflected, many interesting ways to serve one's country, even if the great war were past. this afternoon it struck him that this might become more of a sacrifice than he had anticipated, but notwithstanding his country must always remain first! at the threshold of his own door he stopped, slightly puzzled. some one was already in his sitting-room, which was unusual at this hour. his rooms were cleaned in the morning and he was seldom interrupted afterwards either by a servant or any member of the household. but probably a fellow officer had dropped in to see him and was awaiting his return. suddenly, with this idea in mind, major hersey thrust his door open. then he stood stock still in a slightly apologetic attitude. his room was occupied and by the head of the german household in which he was at present living, colonel liedermann. major hersey had not come into contact with him but once since his own arrival in coblenz several months before. the old german colonel, wearing civilian clothes, was standing examining an american rifle, which the young american army officer had carelessly left propped up against the wall in one corner of his room. the older man wheeled sharply at the younger one's entrance. colonel liedermann had the typical german face, broad, with heavy, overhanging brows, small, stern blue eyes, and drooping jaws. his face reddened at the present moment, but he said courteously: "i owe you an apology for entering your room when you were not present. i came to ask you if you would do me the favor of permitting me to look over some of your american newspapers. germany is not being informed of all that is taking place in the world these days and i should like very much to know. but it is not for myself alone that i make this request. i am an old man and may not live long enough to see the new germany if it is ever possible for germany to arise out of the ashes of the past. but my son, as you know, has never recovered from his last and most serious wound. to lie always in bed after so active a life, grows exceedingly irksome. i find it difficult to keep him even fairly content. it was for him i was asking the loan of your newspapers. i presume the fact that we have so recently been enemies will not preclude your doing me this kindness. if so, i regret my intrusion." a little overcome by the old german officer's haughty manner and set speech, major jimmie only murmured that he would be very glad of course to permit his american newspapers to be read, if colonel liedermann and his son did not feel that they would too greatly resent the american point of view. as he made this statement, although not pleased by the german officer's request, major hersey was searching diligently for the latest bundle of american papers which he had received. as he handed them to the former german colonel, the old officer said, speaking in a more human fashion, "i was interested in looking at this american rifle of yours. naturally as an old soldier i remain interested in firearms, although i shall not live to see another war, however little i believe in a permanent world peace. clever piece of mechanism! i am told the american rifle is the finest in the world!" not feeling called upon to reply to this speech and anxious that the old officer should depart, major hersey made no response. a little later, when he had finally gone, with an unusual expression upon his boyish countenance, major jimmie hersey sank down into his arm chair. was it singular that one could not recover from the sensation of acute distrust in the presence of a german? among them there must be certain individuals who were truthful and straightforward. yet after a century of training that the end justified the means, among german army officers one could not expect to find any other standard, than the standard which regarded the treaty of belgium as a "scrap of paper." betray any friend, any cause, any country to accomplish one's purpose. and tonight, although a member of colonel liedermann's household, major jimmie hersey knew he would always remain their foe, no matter with what appearance of courtesy he might be treated. it was an actual fact that never since his casual conversation with little gretchen, the baby of the family, had he the same sense of untroubled serenity in the midst of this german military home. was it true that captain ludwig liedermann was still unable to move from his bed? if so why had little gretchen told so ingenious a falsehood? one would scarcely expect a little girl of six to make up so useless a story. but if captain liedermann were well why should he continue to make a pretence of illness? there were no penalties attached to the fact that he had been a german officer. could it be possible that he so intensely disliked the idea of coming into contact with the troops general pershing had led to victory, that he preferred invalidism to this other form of martyrdom? there was just one point upon which major jimmie hersey was able to make up his mind during this one evening's meditation. he would suggest to miss jamison that she make no more visits to the liedermann home. he had been surprised to find her returning not once but several times of late. she must understand that the red cross nurses were not supposed to make friends with the families of germans until after peace was declared. the little freia had not been seriously hurt, having entirely recovered from her fright and injury by the next day. nevertheless, miss jamison had made not one, but four or five other calls since her introduction to frau liedermann. of course, as he knew miss jamison but slightly, advice from him might prove embarrassing. she was in reality more hackett's friend than his, although sergeant hackett would deny this fact. he had tried being friendly with nora jamison as she attracted him, but she did not seem to care for other interests than her red cross nursing and the children who surrounded her like tiny golden bees about a honey pot. her ride this afternoon had been her one concession; however, after reaching the red cross hospital, she had said it would be impossible for her to ride again, although she had greatly enjoyed it. in the future nursing and other work she had recently undertaken would occupy all her time. it might be difficult to see nora jamison alone in order to warn her against any too great intimacy with the liedermann family. yet as a fellow american major hersey intended making the effort. he would watch and if she came again to the liedermann house, join her on her way back to the american red cross hospital. chapter xviii _reconciliation_ "i am so sorry you have been ill, bianca." carlo navara had come into bianca's room a few moments before with mrs. clark and now sonya had gone out again leaving them for a few moments alone. it was a fairly warm spring day and yet there was a little fire in bianca's room, for the rooms in the old rhine castle were big and bare and cold, with stone floors. bianca wore a little tea-gown of a warm blue woolen material and had a tea table with a tray upon it just in front of her. she was pouring tea for her guest at the moment he made his last speech. "oh, there has been nothing serious the matter with me, carlo," she returned. "i was simply tired and have been having a delightful rest. i believe when i arrived i said that i should hate to be ill in this dreary old building, but since things so seldom turn out as one expects i have really enjoyed it. besides, i have promised sonya that as soon as it is possible i shall go back to the united states and to school. the red cross experience in europe has been a wonderful one, but now, as i am no longer useful here i must take up the duty, i turned my back upon. it is not going to be easy, carlo, to settle down to a school girl's life after the excitement of war work in europe. yet i have the consolation of realizing that i am only going to do what many of our soldiers will do. lots of the younger men have told me that if their families can afford to send them to college on their return they feel the need of education as they never felt it before coming abroad." bianca extended a tea cup to her visitor. "is this the way you like your tea, carlo? perhaps your taste has changed, but i remember this is the way you liked it in the past." "but my tastes don't change, bianca. it is your mistake to believe they do, neither my tastes in tea nor in friends ever alter." at this carlo and bianca both laughed, although with a slight embarrassment. "i am going back home too, bee, very soon," the young man added. "this is one of the many things i wanted to tell you this afternoon, besides finding out that you were all right again. i talked things over with colonel winfield weeks ago and told him i was getting pretty restless and anxious to return to my work in the united states. i explained to him that a singer can't wait for his career as well as other men, since a voice does not always last a long time. however, i think this argument did not make much of an impression upon the old colonel, but something or other must have, because he asked for an honorable discharge for me and i'm to go home when it arrives. i think the colonel's chief reason was that i am not much good as a soldier here in coblenz. he needs men like major hersey and sergeant hackett. hackett is soon to be a first lieutenant, he should have been one long ago." "i don't see why you have not also been given a commission, carlo," bianca replied, a little jealous for her friend. carlo laughed. "i haven't the stuff in me for an officer, bee. no one knows this better than i do. i am a fair soldier when there is something doing, but a poor one in routine. that is the real test. don't mind, bianca, and don't look aggrieved. i have simply tried to do my military duty like millions of other better men, but now i am going back to the thing i am made for. i was only a soldier for the time i felt myself needed. "by the way i have been learning to sing "siegfried," bianca, studying with my old german singing master. he says i sing the music very poorly, but it has been fun trying to learn. "i know one who lies fast in slumber deep sleeping age long sleep, waiting for thy waking." carlo's voice sounded clear and beautiful in the big room. "if your hair were unbound and you were older you might look like brunhilde some day, bianca." "you are singing better than ever, carlo, i am so glad!" bianca murmured, forgetful of herself. she looked a little paler and more fragile after her illness, yet with her light yellow hair, her delicate features and large dark eyes prettier perhaps than her companion ever remembered seeing her. "and the dancing, bee, i gave that up soon after our talk. i did not need it for diversion after i began my music lessons. besides, miss thompson has taught so many of the soldiers folk dancing and some of them are now so good at it that she no longer wishes me for her partner." bianca colored. "i am sorry i told you i did not like thea thompson, carlo. it is foolish to be prejudiced against people, isn't it? she has been extremely kind to me during my illness and both sonya and i have learned to understand her better. besides, i was prejudiced perhaps because of you," bianca ended frankly. but carlo made no comment. never did it fail to interest him bianca's strange combination of childishness and womanhood. but today she seemed almost altogether childlike. at this instant getting up carlo walked over to the mantel where he put down his tea cup and then stood looking down on bianca. "then we are friends, aren't we, bee? and i hope we may never misunderstand each other again. i have been worried over your being ill and our not being fond of each other in the old way. you may have to forgive me many things and perhaps i may have other friends in the future of whom you may not approve, but you must not think they will make me forget my loyalty to you." bianca was about to reply, but before this was possible sonya clark had opened the door and re-entered the room. she glanced at carlo navara with a slight frown and then walked over and laid her hand on bianca's fair hair. "bee is looking better than you expected to find her, isn't she, carlo, and more like a little girl? i for one am glad her illness has turned her young again. the war in france has made most of us older than we were intended to be, but all the pain and struggle of it was especially hard upon a girl young as bianca. i am going to take her back to new york as soon as dr. clark is able to return and after a year at school i mean to bring her out into new york society as my grown-up daughter. i have always wanted a real one and bianca will be a lovely substitute. don't you think she will probably have many admirers, carlo?" carlo looked a little annoyed. "i thought you had finer ideals for bianca, sonya, than to turn her into a society woman!" he answered with a slight change of manner. "but of course she will be charming. she is that already. and no doubt so many people will admire her that she will learn the pleasant art of forgetting her old friends. i shall probably be in new york only a part of each year. yet somehow, bianca, i hope you will always remain the bianca i have known for the past three years. the war has made the time seem ever so much longer." again bianca was about to reply, but sonya glanced up at a little clock on the mantel. "i am sorry, carlo, but bianca is not allowed to see any one but a half hour at a time. i know she regrets having to say farewell to you, but we are under orders. as for my ideals for bianca, you need not fear. i mean to do all i can to help make her a gracious and lovely woman. and no one is ever to take bianca for granted, carlo, not even you. i think it may be good for her to know that there will be many persons who will think her attractive, as she has too humble an opinion of herself. besides, every girl has a right to a few years of society and a little admiration. i am sure you agree with me?" and carlo was obliged to acquiesce. going back to his quarters, after saying goodby to bianca, he realized what sonya's words and manner must have meant. she considered that he had been too careless of bianca and perhaps thought her affection something which he could possess or lay aside at his own convenience. but if carlo were angered at this idea, he also realized that there was a certain truth in sonya's impression. however, in the future he meant to be more appreciative of bianca's affection, and kinder to the young girl for whom he felt a brotherly affection. chapter xix _a warning_ sooner than he had hoped major hersey had an opportunity for a talk alone with nora jamison. the passing days had wrought no change in his impression that there was something of a suspicious nature taking place in the german household in which he was billeted, a something which was extremely disquieting. nevertheless, so far he really had no tangible evidence which made it possible for him to go to one of his superior officers. unless he had some foundation in fact for his suspicion, it would scarcely be fair or just to involve the members of the liedermann family in unnecessary notoriety and espionage. he must therefore watch and wait until he had discovered some justification for what at present was merely a vague idea. however, there was nothing to prevent his suggesting to a girl, particularly one who was an american red cross nurse, that she try to avoid any appearance of intimacy or even friendliness with a german family, who might later be involved in a serious difficulty with the united states military forces in command of the occupied city of coblenz. three days after reaching this decision, major james hersey was leaving the liedermann house one afternoon just as nora jamison was in the act of entering it. their meeting took place as major hersey was about to open the tall iron gate which led into the yard. indeed he stood aside in order to allow nora jamison to enter. their acquaintance was a slight one, so that it is possible nora jamison may have been surprised to hear the young officer say to her in a hurried and confused fashion. "miss jamison, i must speak to you for a few moments. will you meet me in an hour under the big linden tree in the park where freia and gretchen tell me you are in the habit of playing with them? i am sorry to trouble you but i have what seems to me an important reason for wishing to talk to you." in return, after studying the young officer's face for a moment with her large grey eyes, nora jamison quietly acquiesced. the next instant she disappeared inside the liedermann house, the door being opened for her almost instantly by frau liedermann herself. it was possible that the german lady may have observed their brief conversation, yet jimmie hersey had no suspicion of frau liedermann, who struck him as being an outsider in the family of her husband. an hour later, when major hersey sought the place he had chosen for their appointment, he discovered nora jamison was there before him. she was sitting on a small bench under a great tree filled with tiny flowering blossoms which scented the air with a delicious fragrance. evidently she was thinking deeply. nora jamison's exceptional appearance did not attract the young officer, although she did interest and puzzle him. her short hair, her slender, almost boyish figure, the queer elfin look in her face, which made one wonder what she was _really_ thinking even at the time she was talking in a perfectly natural fashion, had a tantalizing rather than a pleasant effect upon some persons. yet once seated beside her major jimmie felt less embarrassment than he had anticipated. one had to believe in any human being for whom children cared as they did for this american girl. "freia and gretchen talk about you always," he began a little awkwardly. "i thought at the beginning of our acquaintance that i was to be their favored friend, but soon found you had completely won their allegiance. but where is your usual companion, the little french girl?" "i left her at the hospital today, major hersey; for a special reason i wished to make a call upon frau liedermann alone. but please do not let us talk about freia and gretchen at present though they are dear little girls. you have something you specially want to say to me and i must be back at my work at the hospital in another half hour." major hersey was a soldier and nora's directness pleased him. "yes, it is absurd of me to waste your time," he returned. "the fact is simply this. as i am billeted in their house for the present i cannot very well have failed to notice that you are developing what looks like a personal intimacy with the liedermann family. i presume you know that the americans in coblenz, who have anything to do with the united states army, are not supposed to fraternize with the germans. you may regard it as impertinent of me to recall this fact to your attention. i presume you consider that this advice should come from some one in more direct authority over you, but i assure you i only mean to be friendly. i have no real evidence for my statement, but i am under the impression that certain members of colonel liedermann's family are still extremely hostile to their conquerors. moreover, you yourself realize that as the terms of peace are delayed there is not merely a sense of irritation and discontent with the present german government, but attempts are being made both secretly and openly to overthrow it. i have mentioned my suspicion to no one except you, miss jamison, which of course shows my confidence in you, but it has occurred to me as a possibility that colonel liedermann, or his invalid son, may be less reconciled to existing conditions in germany than they prefer to pretend. later, if a discovery of this character should be made, i would regret to have any one of our american red cross nurses drawn into such an uncomfortable situation." annoyed with his own confused method of stating a situation, major jimmie hersey paused, coloring in his usual annoying fashion, as if he were a tongue-tied boy. yet his companion was looking at him without any suggestion of offense, and rather as if she too were pondering some important matter. "thank you for your advice, major hersey," she replied the next moment. "now i am going to ask you to trust me. i have a reason for going to the liedermann house and i must go there perhaps several times within the next few days. afterwards i may be able to explain to you my reason. will you trust me and not report my actions to any one for the present?" with nora jamison's eyes facing his directly, although against his own judgment, there was nothing the young officer felt able to do but agree to her request. yet it was out of order and it appeared to him that nora jamison was being vague and mysterious. it were wiser if she attended strictly to her red cross nursing. surely some one of the other red cross nurses had told him that this miss jamison was not inclined to be especially intimate with any of them. that same afternoon after several hours of indoor work, making out a report for his superior officer, major james hersey felt that he was rewarded for the day's duties by an afternoon ride with the countess charlotta. as they had no other chaperon for their ride, miss susan pringle had consented to accompany them, rather to major jimmie's consternation. he feared that she was taking an incredible risk with her own health and safety in order that her adored young countess should not be disappointed. yet it was soon evident that the middle-aged english spinster was an accomplished horsewoman. along the rhine that afternoon in the late april sunshine the water shone like rusty gold. high on the opposite hills the old feudal castles looked to major jimmie like the castles he had read of in the fairy stories of his childhood. moreover, it was easy even for a prosaic soldier, such as major james hersey considered himself to be, to think of the little countess charlotta scherin as the heroine of almost any romance, even of one's own romance. chapter xx _nora jamison explains_ it was toward the end of the same week that a note arrived for major james hersey from sonya clark. she asked him to make an appointment with colonel winfield in order that he might see her and one of her red cross nurses as soon as possible. would major hersey also try to be present? there was a reason, which he would understand, why his presence might be necessary. colonel winfield and sonya clark were great friends, as the colonel had been one of the commanders of a regiment stationed near the red cross hospital in the neighborhood of château-thierry for many months before the close of the war. the colonel, however, was not in his library at the moment of major hersey's arrival. sonya clark and nora jamison were there awaiting his appearance. "we are a few moments early; i suppose the colonel will be here directly," sonya remarked. "you may not approve of our having come first to the colonel's quarters instead of seeing one of the heads of our secret service," she continued, "but since neither miss jamison nor i knew exactly what we should do, we decided to make a report directly to you. then you will know what should be done. secrecy seemed to us of first importance." during sonya's speech colonel winfield had come into his room and now apologized for his delay. nora jamison had never met the distinguished officer before, and therefore looked a little frightened, but a glance at major jimmie's interested face reassured her. after all he was the one person who would substantiate the story she had to tell, for even if he had no positive evidence at least his suspicions would coincide with her knowledge. "you are sure there is no one who may overhear us, colonel winfield?" she asked a little timidly. "i think when i tell you what i am about to that you will understand why one still has reason to suspect almost any one in germany, although the good of course must suffer with the evil." colonel winfield nodded. "i understood from mrs. clark that you wished to talk to me on a private matter and i have one of my orderlies stationed at the door. there is no chance of being overheard. as for continuing to feel suspicion of the enemy, while the american army is policing the rhine it is our business to take every precaution against treachery. at present i wish i could be more certain that the state of mind among the inhabitants of coblenz is what it appears upon the surface. tell me what information you have and how you have acquired it. there is a possibility that i may not be so much in the dark as you at present suspect, miss jamison." "if you don't mind, may i take off my hat while i talk?" nora jamison asked. "it is boyish of me, i suspect, but i can talk better with my hat off. do you happen to know, colonel winfield, that there are persons in germany who are friendly to the kaiser in spite of all that he has made them endure? actually they do not seem to realize that he is chiefly responsible for the tragedy of their country and her present position as an outcast among the nations." "yes, i quite understand that fact," colonel winfield returned drily. "then do you also know, colonel, that there are men and women in germany today who are anxious to rescue the kaiser from his fate. they would make any possible sacrifice to save him from being tried by an international court in case the allies decide upon this course. but perhaps i had best tell my story from the beginning and you must forgive me if some of it appears confused." at this instant, clasping her hands together in her lap, nora jamison sat staring straight ahead, but looking at nothing in the room, rather at some mental picture. "when i came to europe i hoped to be of service as a red cross nurse, but by the time i arrived the war was over and the armistice about to be signed. still i hoped i had not come altogether in vain and persuaded dr. clark to bring me with him as a member of his red cross staff who were to serve with the american army of occupation in coblenz. "i felt a good deal of bitterness in coming into germany. the young man to whom i was engaged was killed by the germans near château-thierry. i know it was wrong and yet i felt as if i would like to revenge myself upon them for all i have suffered. i must apologize for telling you this, but you will see that it does bear upon my story. "well, after i came to germany, although i discovered that i did dislike and distrust the german people, yet i could not make up my mind not to feel affection for the little german kinder, who after all were in no way responsible for the war. i always nursed children before i joined the red cross and have a special fondness for them. the little french louisa and i, who are always together except when i am at work, made friends with a number of the german children. among them were two little girls, whom major hersey will tell you are especially attractive. but if i seemed to single out these two children and especially the older one, freia, it was not because she so greatly attracted me. early in our acquaintance the little girl told me an anecdote which struck me as extraordinary and almost immediately aroused my suspicion. please don't think i found out at once what i am trying to tell you, i at first had to piece things together. "freia told me that her brother, captain ludwig liedermann, who had been wounded, had recovered, but would not leave his room and did not wish any one to know he was well. freia received the impression that he did not wish to be seen by any of the american officers or soldiers in coblenz. he once told little freia that he hated to meet the men who had defeated their emperor and driven him into exile." the colonel nodded. "yes, well, that strikes me as if alone it might be a sufficient reason. i would not be surprised if there were other german officers and soldiers hiding from us with this same excuse. however, we shall remain on duty in germany until both the military and the civilians find it wiser not to seek cover in order to escape the consequences of their past." "yes, i know, but this did not seem to me all there was in freia's story," nora continued. "so i confess i made friends with the little girl largely in order to gain her further confidence. she afterwards told me other things that were puzzling. i knew that the germans in coblenz were not allowed to hold secret meetings, but freia insisted that officers who had been old friends of her brother's came constantly to their house and that her sister hedwig opened a side door for them, so they would not disturb major hersey. then they talked together a long time and no one else was allowed to enter her brother's room, save her father. she also spoke of her sister hedwig's hatred of the americans. it seems that fraulein liedermann and i have at least one experience in common. the german captain to whom she was engaged was also killed in the war. hedwig was angry because her little german half-sisters were willing to make friends with major hersey and me. but i must not take so long to come to my point. i also made friends with frau liedermann. often i went to her house, although always i was afraid that the fact would be reported. if i was found to be fraternizing with the germans i would have been forced to end my acquaintance with the liedermanns, as you know. "i can't tell you near all the details, but the important fact i discovered is this: captain liedermann, the colonel his father, and a number of other german officers have for weeks been making a secret effort to have the kaiser spirited away from holland. their plan is to conceal him in some spot where the allies will be unable to discover him. then, when the resentment against him dies down the kaiser will be rescued and brought back to germany. captain liedermann has been trying for a long time to get out of coblenz. but i cannot tell you anything more than this bare outline of the german plan." breathless and shaking a little from fatigue and excitement, nora jamison now paused. "you mean to tell me that you have made this extraordinary discovery during your occasional visits to the liedermann home, when i who have been billeted there for months have learned nothing?" major hersey demanded, coloring in his habitual fashion, but this time partly from admiration of the girl beside him and partly from annoyance with himself. "yes, but our positions have been entirely different, major hersey," nora explained. "every precaution was taken to see that you found out nothing. indeed you were apparently welcomed into the liedermann household so that your presence there might be a blind. what i found out was owing to my intimacy with the two little girls and later with frau liedermann. i hope for her sake it may never be discovered just how much she did confide to me. i sometimes think she almost wanted me to report what i knew, she is so weary of war and intrigue and deception, and is almost as much of a child as her two little girls. i think this is all i have to tell at present. if our intelligence department should wish to ask me questions later, why i may be able to answer them." colonel winfield rose and walked over to nora. "you have given me extraordinarily valuable information, miss jamison. i shall see that it reaches the war department at once. i have always insisted that women make the best members of the secret service. but under the circumstances i feel that i have the right to tell you this. we did know something of this plot you have just unveiled. what we did not know was where to find the centre of the conspiracy in coblenz. i think you need have no uneasiness, the kaiser will never be saved from the consequences of his acts while the allied armies are policing the rhine. however, miss jamison i am glad to have had you in coblenz and think you have justified your coming to germany. may i congratulate a red cross girl for another variety of service to her country. now you are tired, shall i not send you back to the hospital in my car?" but sonya clark shook her head. "no, thank you, colonel winfield. dr. clark is to have one of the red cross automobiles come for us, which is probably now waiting around the corner. we wished our visit to you to be known to as few persons as possible. major hersey will see us to the car. goodby." chapter xxi _the rainbow bridge_ one afternoon in may, sonya clark was entertaining a number of friends among the american officers and soldiers in coblenz in the garden back of the american red cross hospital. during the early spring the red cross girls had devoted many leisure hours to digging and planting flower seed on the level space just behind the old building and overlooking the banks of the rhine. this afternoon this spot was gay with spring flowers, also there were old rose vines climbing high on the grey stone walls, now a delicate green but promising a rich bloom in june. these were troubled days in germany, the most troubled since the arrival of the american army of occupation. a short time before the allied peace terms had been presented to the german delegates in versailles; since then all germany had been crying aloud protests against a just retribution. germany was in official mourning. yet the americans in coblenz, soldiers and civilians alike, were undisturbed, knowing germany would sign the terms when the final moment arrived. today something of greater importance was taking place among sonya clark's and dr. david clark's friends. this little reception was their farewell. in a short time they were returning to new york taking with them a number of their staff of red cross nurses. several days before a new unit of red cross workers had arrived in coblenz, relieving former members who desired to return home. the afternoon was a lovely one, now and then occasional light clouds showed in the sky, but away off on the opposite bank of the rhine there were lines of blue hills, then purple, fading at last to a dim grey. sonya and dr. clark were standing among a little group of friends. nona davis and mildred thornton were beside them. both of the original red cross girls were wearing decorations which they had lately received from the french government and the united states government in recognition of their four years of war nursing among the allied armies of europe. they were leaving with sonya and dr. clark for the united states and were expecting to be married soon after their arrival. colonel winfield, who was an old friend, was congratulating them and at the same time lamenting their departure from coblenz. "i wonder if you will tell me just what members of dr. clark's staff are going with him?" he inquired. "i fear i shall feel a stranger and an outsider at the american red cross hospital when so many of you sail for home who were with me in the neighborhood of château-thierry, caring for our wounded american boys. may your married life be as happy as you deserve." slipping one hand through the elderly colonel's arm, nona davis suggested to him and to mildred thornton: "suppose we take a little walk; no one is noticing us with sonya and dr. clark the centre of attention. whatever i may dislike about germany, i shall never forget the fascination of many of the views along the rhine during this winter and spring in coblenz. "as for the members of dr. clark's staff who are going home with him, there are no nurses who will not remain except a miss thompson. bianca zoli, mrs. clark's ward, is leaving with her of course. then i suppose you know that the little luxemburg countess charlotta scherin and her governess are to accompany us, i believe with the consent of her father." as the little group moved away in the direction of the river bank, mildred smiled. "see, colonel, there are the three girls we have been discussing! the little countess charlotta and your pet officer, major hersey, are probably saying farewell. further on is theodosia thompson and dr. hugh raymond. dr. raymond is to be in charge of our american red cross hospital in coblenz after dr. clark's departure. it is a good deal of responsibility for so young a physician, but dr. clark seems to think he is equal to it. and there perched up in the branches of that old tree is bianca zoli. how pretty she looks in her delicate blue dress against such a background!" "and who is that romantic young soldier standing beneath her?" the colonel demanded. "oh, yes, i remember now, he is the soldier-singer, who i believe is also going back to the states, as i secured an honorable discharge for him a short time ago. odd name his for an american, what is it?" "carlo navara," nona replied, "and an old friend of ours." then they continued on their walk. at the same moment theodosia thompson and dr. raymond were slipping out of sight of the guests along a little path which ended in a group of shrubs a few yards down the hill. "i can't see why you wish to renew what we were discussing a few days ago, dr. raymond," thea argued a little plaintively, her red hair shining in the warm light, her pale cheeks showing two spots of bright color. "i think i said to you then all i could say. i do appreciate the honor of your believing that you care for me, although i think you will soon find out your mistake. you will see then as plainly as i do now that we are not suited to each other. i told you i did not wish to marry any one. i know it seems ridiculous and perhaps wicked to you that i should prefer to learn folk dancing as a profession rather than to continue as a nurse. but people cannot always understand each other's dreams and desires and i only undertook the red cross nursing because i wanted to help nurse our soldiers, not because i wanted to be a nurse always. but ruth carroll believes as you do and never intends giving up her work, not unless she marries which i hope she may some day. she is so splendid and restful, just the kind of girl i should think an ambitious man would care for. she would be such a pillar of strength. alas, that i shall never be to any one, not even to myself i am afraid!" thea ended. then she put out her hand. "don't let us argue on this lovely day, dr. raymond, just shake hands with me, and let us wish each other good luck." under the circumstances, since there was nothing else to do and also because he was partly convinced of the truth of thea's speech, dr. raymond agreed with her request. a few moments later, climbing up the hill, they rejoined the other guests. from the ground, smiling up at her in a teasing fashion usual in their relation to each other, carlo at the same time was saying to bianca zoli: "sure you are not especially glad to be going home, bianca, chiefly because i am so soon to follow you? i've an idea you would be very unhappy if we were parting for any length of time. nicht war?" bianca shook her head, smiling and at the same time frowning. "under those circumstances, i should simply have tried to bear my departure bravely, carlo, as one who has been through a good many experiences as a red cross girl in time of war. but don't speak german even in fun. some day i may learn to dislike the language less, but not at present. moreover, i do not look forward to seeing a great deal of mr. carlo navara even if we are both again to be in the united states. you will be very busy with your career and will probably soon be a more famous person than you were before you entered the united states army, while i, well i shall work hard in my way, although i shall continue to remain an obscure person." "i don't know, bianca, suppose some day you condescended to marry me. wouldn't you like to share my fame?" bianca shook her head. "i think not, carlo. besides, you must not say things of that kind to me. you know sonya would be angry." carlo looked a little annoyed, then laughed. since her illness it seemed to him that bianca had changed in some subtle fashion. one was no longer so sure of getting the best of her in an argument. besides, after all, would it be so unpleasant to share one's future with bianca? she looked oddly pretty and ethereal high up in the branches of the tree where he had lifted her a few moments before. but at this moment there could be no further discussion between them, a message arriving from sonya saying that she wished bianca to come and assist her in pouring tea. after he helped her down to the ground, carlo made bianca pause for a moment while he pointed across the river. "see that curious effect, bianca! there is a rainbow over the rhine. it comes sometimes in the late afternoon light even when there has been no storm. let us hope the world will find peace at the end of the rainbow, and more especially germany. i won't come with you now, as i hate having to serve tea. ask some of your soldier friends who are cleverer at it than i. i want to watch the sunset on the rhine." and carlo and bianca parted for a short time, yet thereafter many experiences and a number of years were to roll between them before carlo and bianca at last found happiness in each other. at the same time major hersey and charlotta were observing the curious effect of light over the river. they had gone together to the edge of one of the cliffs and were gazing across at the great fortress of ehrenbreitstein from whose tower the stars and stripes were floating. to them the rainbow seemed to dip down into the depth of this ancient fortress and lose itself in the shadows. "whenever i am homesick to return to my own country, countess charlotta, i simply stare across at the flag on that old german fortress and think what it represents," major hersey declared. "then i am content to remain in germany for as long as i am needed. a little thing, isn't it, to give a few months, or a few years, or whatever length of time may be necessary to teach germany her lesson, when so many other men have given their lives that our flag be the flag of victory and a just peace!" the young girl's face softened. "i think you are a good soldier, major hersey. there is something i want to confide to you. i did write my father as you suggested and told him i would come home if he wished, only he must allow me to keep my freedom. his answer was what i expected. he does not desire to see me at present and says i am free to travel in the united states if i like. only he adds that when i have seen more of the world perhaps i shall be more content to do my duty to my father. not very clear, but i think i understand. my father really wishes to become reconciled with me, only not to seem to give in too readily. so i shall return home in a few months perhaps. then if you are still in coblenz and i write you, won't you come to luxemburg? we have been such good friends and i hate saying goodby forever to people i like." major jimmie hersey shook his head, his brown eyes were steady and although the old boyish color had diffused his face, there was the firm line about his mouth and chin which his soldiers knew and respected. "no, countess charlotta, i shall not come to see you in luxemburg or elsewhere and this must be our goodby. i have no idea of leaving the united states army so long as i am allowed to remain in it. this means i will have nothing to offer you in the future, save what i have now, i believe you understand." the countess charlotta nodded. "yes, i understand. goodby, yet nevertheless i shall look forward to our meeting again." * * * * * transcriber's note: obvious punctuation errors were corrected. page , "amunition" changed to "ammunition" (long road ammunition) page , "occured" changed to "occurred" (must have occurred) page , "sherin" changed to "scherin" (scherin dropped back) page , "that" changed to "than" (older than she was) page , "windoes" changed to "windows" (windows one could) page , "refuse" changed to "refused" (parents refused to pay) page , "her's" changed to "hers" (hand in hers) page , "hacket" changed to "hackett" (donald hackett went over) page , "goodbye" changed to "goodby" to match rest of usage (when we said goodby) page , "embarassing" changed to "embarrassaing" (asked no embarrassing) page , "noticably" changed to "noticeably" (noticeably pink) page , "faulein" changed to "fraulein" (to bring fraulein jamison) page , "aggreeable" changed to "agreeable" (could not be agreeable) page , "embarass" changed to "embarrass" (embarrass the american) page , "prefering" changed to "preferring" (the interior, preferring) page , "sherin's" changed to "scherin's" (what the count scherin's) page , "thronton" changed to "thornton" (and to mildred thornton) page , "states" changed to "states" (back to the states) a nurse's life in war and peace by e. c. laurence, r.r.c. author of "modern nursing in hospital and home" with a preface by sir frederick treves, bart. g.c.v.o., c.b., ll.d. london smith, elder & co., waterloo place [all rights reserved] printed by ballantyne, hanson & co. at the ballantyne press, edinburgh preface the charm of these letters, it will at once be found, depends upon their simplicity, their artlessness, their obvious candour. they present a plain, untinted account of a nurse's career, of the difficulties she has to face, and the problems she has to solve. those who wish to know something of a nurse's life and times will find in this writing a convincing narrative, unemotional and matter-of-fact. this is no small merit, since the record of nursing experiences is apt to be blurred by exaggeration or made nauseous by sickly romance. there is pathos enough in the sick-room and in the presence of death, but those who come in touch with it would do better to hush the knowledge in their hearts, rather than to proclaim it on the house-tops. apart from this, the world must be a little weary of the astute sick child who lisps melodrama into the ear of the "kind nurse," as well as of the bizarre aphorisms of the dying tramp. the faults of management and lapses of discipline which crop up incidentally in the story are now matters of the past, and are no longer to be found in either the "children's hospital" or the "general." the novice who is entering the profession of nursing will find in these letters a sensible and exact view of the prospect that lies before her. she may further glean some insight as to the qualifications of the good nurse. these qualifications are to be expressed neither by certificates nor by badges, neither by starched uniforms nor by examination results. they are happily beyond the mechanical gauge of any examiner, and above the platitudes of the official testimonial. of the perfect nurse it may be said that "her price is far above rubies," and that her place is high in the company of admirable women. she is versed in the elaborate ritual of her art, she has tact and sound judgment, she can give strength to the weak and confidence to the faint at heart, she has that rarest sight which can see the world through the patient's eyes, and she is possessed of those exquisite, intangible, most human sympathies which, in the fullest degree, belong alone to her sex. frederick treves. _december ._ contents i page at school--determined to be a nurse--royal red cross instituted--preliminary training ii visit to tenerife--a storm in the bay--the beauties of the island iii up the cañadas--voyage home on a cargo-boat--call at madeira iv first experiences in a hospital--the food--some medical cases--my first "special" case v moved to a surgical ward--in quarantine--a poisoned hand--"kathleen" vi in the out-patient department--food improved, and heavy work reduced--act as night sister for two nights--am offered a post as staff nurse--my first certificate vii to south africa for a year--voyage out on the _scot_--by train from cape town to kimberley viii life on the diamond fields--i meet mr. cecil rhodes--the kimberley exhibition ix a visit to cape town--up table mountain--return to kimberley x on circuit in cape colony--a visit to natal--the doctor's fee xi east london and port elizabeth--down a diamond mine (kimberley)--return to england xii accepted for training at a general hospital--i begin in a medical ward--a sudden death xiii on the surgical side--a heavy "take-in" week--lectures on physiology xiv my first typhoid case--diphtheria tracheotomies--the rescue of the cat--on night duty xv christmas in hospital--the dispensing examination--acting assistant matron--three weeks on duty in an infirmary xvi first sister in the front surgery--a bad accident--a dog with a broken leg xvii temporary ward sister--appointed night sister--interesting work--join the royal national pension fund for nurses--i spend christmas warded as a patient xviii chloroform for a cat--i volunteer for plague duty (refused)--appointed ward sister--a fire alarm--a holiday in switzerland--a bomb in paris xix i go to egypt--nursing at sea in rough weather--at helouan--ride out to the pyramids--the kasr-el-aini xx up the nile by tourist steamer--at luxor--"hare and hounds" on donkeys xxi war in the soudan--night and day nursing xxii sent up to assouan--down the nile on a post boat--a saunter home across the continent xxiii back to my old hospital--in a ward for women and children--christmas in a men's accident ward xxiv scarlet fever--at marlborough house with r.n.p.f. nurses xxv the boer war--a lucky meeting at the war office--joined the army nursing service reserve--choosing fittings, &c., for a hospital of beds xxvi voyage out on the _tantallon castle_--some military hospitals near cape town--we land in natal xxvii inoculated against typhoid--we begin to build our hospital--increased from to beds--unpacking--a hospital ship at durban xxviii our food supplies--washing arrangements--snakes and other creatures--a railway accident--our first patients xxix the princess christian hospital train brings us some bad cases--men from elandslaagte--some officer patients--the bishop of pretoria xxx dengue fever amongst the staff--first death amongst the officer patients--mafeking relieved--our hospital officially "opened"--colonel galway--the trappist monastery xxxi a spion kop hero--orderlies knocking up with enteric--worsted work, &c., to amuse the convalescents--death of an orderly from enteric--poem by officer patients xxxii some distinguished visitors--we become a military hospital--new orderlies arrive--"imperial bearer company" men--our major xxxiii changes on our staff--the arrival of sick convoys--our servants--the hospital commission--the difficulties of transport xxxiv i visit the battle-fields--at colenso--ladysmith--up spion kop--tin town hospital--on a red cross ambulance xxxv the tugela falls--pieter's hill--hart's hill--chieveley--mooi river--maritzburg--back at pinetown xxxvi prisoners from pretoria--our gardens--we start poultry keeping xxxvii the natal volunteers return home--"john"--flying ants and other plagues xxxviii the buckjumper--the excellence of the boer ponies--the home for lost dogs! xxxix sudden orders for home--voyage with lord roberts on the _canada_--call at cape town--a funeral at sea xl lord and lady roberts visit the hospital--christmas at sea--we anchor off cowes--lord roberts visits queen victoria at osborne--sixteen days' leave--rejoin the _canada_ to return to the cape xli the death of queen victoria--lodgers at wynberg--the plague at cape town--up the coast with boer prisoners xlii up country--under canvas--the sisters' horses xliii our tent flooded--a cow shares my tent--night duty in the rainy season--afternoon duty xliv in charge of medical tents--a present from the queen--within sound of the guns--"kit inspection"--the horrors of transport in the ambulance waggons xlv a sudden collapse--the winter begins--tired of the war xlvi night duty again--a sick convoy arrives in the night--a bad pneumonia case--nearly frozen xlvii mentioned in despatches--ill with dysentery--a night at pinetown--with my brother to uitenhage xlviii at port elizabeth--down the coast to mossel bay--we drive, _via_ george, to oudtshoorn--martial law--under escort to prince albert road--by train to kimberley xlix tales of the siege--"long cecil"--refugee camps--a picnic under arms l by train to cape town--night sister on a troopship--some sad cases--home once more a nurse's life in war and peace i the school, lincoln, . this is my usual day for writing letters, and i have nothing but the usual things to write to you about. each day we get up at the same time, do the same sort of lessons (not very difficult), eat the same sort of food (not very interesting), and go for the same dull walks, with an occasional game of tennis on a badly-kept lawn; but i have been thinking, and the long and short of it is, that i am going to persuade my people to let me leave school. i think you know that some years ago i determined that i would be a nurse. to be exact, it was in that queen victoria instituted the royal red cross, and in the same year i was grieving over the fact that none of the professions in which my brothers were distinguishing themselves would be open to me, as i was "only a girl"; so i at once decided that i would try to win the royal red cross. well, i am not thinking so much about the decoration now, as wars seem to be few and far between; but still i think the nursing profession is the only one i am a bit fitted for, and lately i have been reading everything i can get hold of on the subject. you see, i am not a bit clever, and i am no good at music or languages; so i could never teach. and, on account of having been so delicate when i was small, i am behind most girls of my age in many subjects; but in the two terms that i have been here i have won two prizes, and i think i can work up any subject that i want to as well as most people can. i know i am not old enough to begin nursing yet, but when i am, it may be necessary to pay for my first year's training, so i very much want them to save the money they are now paying for my education to pay for that, as it seems to me that i am being stuffed with many subjects that, after i leave school, i shall have no further use for. i have not yet quite decided which hospital i shall go to. it is clear that if i want to join the army nursing service, i must go in for three years' training in a good-sized general hospital first; but the best of these hospitals won't accept candidates till they are twenty-three, and that seems such a very long way off. so perhaps i may take a preliminary year in a children's hospital, or some other special hospital first, but i am not old enough even for that yet; and as i think f. is going out to the canary islands for the spring, i think it is very likely i may go with him, as you know i love travelling. i like this place very well, and i have many friends here; but one thing is quite definite, and that is that i mean to be a nurse, and with that in view i think i might be employing my time more profitably than i am doing here. ii port orotava, tenerife, _april _. here we are, in comfortable quarters and in glorious sunshine, the grand old peak of tenerife (with its cap of snow) looking down upon us. i wish you could be transplanted to this warmth and brightness; but you would not have enjoyed our experiences on the way here. you know how cold it was when we left london on the _ruapehu_; and all down the channel it was very cold, but fine and calm. we called at plymouth (such a pretty harbour); then, after we left there, our troubles began. the next day there was a heavy swell, and very few people appeared on deck. our stewardess, they said, had "happened of an accident," but we were well waited upon by a nice little steward. m. was bad, and stayed in her berth; but with the steward's assistance i struggled up on the upper deck, and i would not have missed it for anything. towards evening it was really blowing hard, and the waves were grand. we took such plunges down into the trough, and then the great ship trembled, and seemed to pull herself together to rise on the crest of the next wave and then take another plunge. the men were on the trot all day, making everything fast. it was sunday, but there was no service--the crew all too hard at work, and the passengers chiefly in their berths. towards evening i was wondering how i should "make" my cabin, when the purser came along and asked if he might help me down below, as the wind was still rising, and he had been appointed "runner-in" by the captain, who said we had all better be down below. that night and the next day were really very bad indeed. we were battened down, and the dead-lights were screwed on about . p.m., and the electric light supply did not come on till after six; so for that time we were in darkness, and some of the passengers were really very much frightened. tons of water poured on the main deck and down the companion-ways, and men were bailing it out near our cabins all night long. i kept feeling in the dark to see if there was water in our cabin, as it rushed past the door with a great "swish"; but the step was high, and it did not come over. there was no sleep for any one that night; it was all we could do to keep from being pitched out of our berths. the men were very funny as they bailed the water out and mopped up. "reminds one of washing-day in our backyard--pity my old woman ain't here," "sometimes we see a ship, sometimes we ship a sea"--and heaps more to the same effect. our steward said he had never had to bail out so much water before, and he had been six years on the ship. one of the sails was carried away; and when we got to santa cruz the engineers discovered that part of the rudder had gone. two cooks and one of the sailors were knocked down and injured, but i think not very badly. two of the boats were washed out of the davits, and one of the heavy deck-seats (next to the one on which i had spent the afternoon) was smashed to bits. sleep was quite impossible, as it was most difficult to keep in one's berth, and every now and then there was a great crash as things were broken in the saloons and galleys. we are still bruised and stiff from the knocking about. i have always wanted to see a storm at sea; but i am now quite satisfied, and i shall never want to see another. it is most unpleasant to be battened down, and the engines sound to be so fearfully on the strain and tremble that you feel you must listen for the next beat of the screw, knowing that if the engines should fail your chance of weathering the storm would be a very small one indeed. after that the weather improved, and also became warmer, and the passengers one by one came crawling up on deck; but most of them looked as though they had been through a long illness, and could talk about nothing but their alarm in the storm; and the captain owned he had had a very anxious time. we landed at santa cruz early one afternoon--a very unsavoury town, with dirty beggars exhibiting various loathsome diseases and following you about. after a little delay we secured a carriage and three horses to drive across the island to orotava, twenty-six miles distant--a pretty, winding road, cool up in the hills, but becoming hot as we descended to puerto orotava. the hotel was full, but we secured rooms in a dependence; and when we had rested and changed, we found a _carros_ ready to take us across to dinner. a carros is a kind of sledge on broad runners drawn by two oxen. they are much used in the town, as the roads are paved with little cobbles, which would pull the wheels about a great deal. this is a nice hotel, cool and airy, and the garden is lovely--such quantities of roses, bougainvillias, and bright trees of hibiscus. there is a good billiard-room we can use, and it is open all down one side (only matting blinds). that shows how dry the climate is, as the table is perfectly "true." the waiters are spaniards, who know a little english and like to use it. "this is jarm, very goot," &c. we go about with our little red book of phrases, and sometimes get what we want, but more often fail to make ourselves understood. the natives are most interesting, the children such pretty little things with very bright eyes. up in the hills they still consider it is winter, and the men go about with blankets tied round their necks; and when they squat down on the ground, the blanket flows out and makes a little tent round them. down here it is really hot, and the small children wear nothing but a little chemise. the women are pretty, and they wear brilliant-coloured handkerchiefs tied over their heads. we are close to the sea, and it is such a gorgeous blue; i have never seen anything like it before. i suppose it is very deep round here, and the peak rises , feet, straight from the sea. there is no english church yet, but the chaplain holds services in a large room fitted up as a church. every one rides when he goes anywhere here, even when going to church; so during service there is a large company of ponies and donkeys outside, with the attendant men and boys (all in white suits, with bright-coloured sashes), and now and again the donkeys lift up their voices. i have found a good chestnut pony ("leaña") that goes well. they are sure-footed little beasts here; and it is necessary for them to be so, as there is only one "made" road, and for the rest we scramble up mountain paths. but when we get on the road they simply scamper along. m. has not done much riding; and sometimes, when we are scrambling up a steep place, i look back, and find her holding on for dear life with a most resigned expression on her face. but i think she is enjoying it all immensely. we walked up to the botanical gardens the other day, and they are perfectly beautiful--arum lilies and many of our choicest greenhouse flowers growing like weeds, and the ferns here are so beautiful too. up in the kloofs (here called _barrancos_) we find maidenhair growing wild, and in such enormous fronds. i measured one, and it was two feet high. at the gardens a very handsome young gardener--a spaniard--gave us huge bunches of roses to bring away. all the natives we come across are so polite and friendly (every man you pass raises his hat), we wish we could talk spanish to them; but so far, if we can ask for what we want, it is quite as much as we can manage. the better-class people often speak french, and i get horribly mixed. the other night a solemn señor asked me if i spoke french, and i said, "_un très mui poco_"! the word they seem to use the most is _mañana_ (to-morrow); as our nice waiter explained when a gentleman said, "antonio, the coffee is cold," "ah, it shall be hot to-morrow. with the english it is always now, to-day; with us it is _mañana_." we hear that laguna is the fashionable resort as soon as it becomes too hot down here, but that icod is the fruit-growing village of the island; so we think of driving over and spending a night there. iii ss. "fez," english channel, _june _. since my last letter we seem to have been chiefly engaged in wrestling with steamship companies in the vain endeavour to persuade them to remove us from the island. f.'s leave was up early in june, and as we had return tickets by one line, we wrote to them in good time to secure berths. at first they made us various promises; but soon we learnt the truth--namely, that all their boats were full in every berth long before they came near the island. then we began to tackle other lines; but, you see, nearly all the boats come from new zealand or the cape, and this is the favourite time for going home; also there is the attraction of the paris exhibition. so i cannot tell you on how many ships we have applied for berths, and always in the end received the news, "every berth full." personally i did not mind, as i enjoyed every day on the island; but it was awkward for some things, and eventually we had to decide to sail on board a small cargo steamer that calls at orotava instead of at santa cruz, and carries a few passengers home at a leisurely speed. but before i tell you of the voyage, i must tell you a little about our last few days on the island. one day we drove over to icod, a pretty little village about two hours' drive from orotava. much coffee is grown at icod, and also plenty of fruit--oranges, lemons, figs, &c. we rode from there to gerachico (a pretty ride along the shore), where a whole village was engulfed when the peak last erupted; but it is now again built over, and we could not see much of interest remaining. señora carolina reigns at the small icod hotel, and made us very comfortable. but neither she, nor any one we met in the place, spoke any english; so it was good practice for us, and our spanish came off better than i thought it would. we decided not to climb the peak, as you cannot do it from orotava without spending a night somewhere up the mountain; but one day m. and i joined a party for a day on the cañadas--the range from which the peak rises. we mounted our ponies at a.m. in brilliant sunshine, and at different points picked up our friends, till we were a party of ten, with a crowd of attendant boys to carry our lunch, &c. the first part of the ride was easy and pleasant; then, as we got higher, it became more of a scramble over loose stones, that any english pony would have said were only fit for a goat to be asked to walk over. just as the path was becoming really steep we left the sunshine, and found ourselves in a thick bank of clouds, cold and damp, and had to go very cautiously, in single file. the chattering pony-boys were very silent (their spirits are easily damped), and said it was "_mucha frio_." soon we emerged above the clouds into a scorching sun, and, finding a piece of fairly level ground, some of us took a little canter to try to get warm; but we came to a sandy place, and there leaña took it into her head to lie down and roll. i saw what she was up to, and managed to roll out of her way; so my saddle was more damaged than i was. but as my clothes were very wet with the mist, the sand adhered! we had a pleasant lunch, at a height of feet, while the ponies were off-saddled and fed; and some of us thought we should like to camp for the night and climb the peak in the morning. but when we had finished lunch we had only two ham-sandwiches left between us, so concluded we had better return before night. the view was lovely, looking _over_ the banks of snowy-white clouds to the very blue sea, with the other islands in the distance, and behind us the grand old peak. the ride down (a different way) was rather perilous, the ponies jumping from rock to rock in a perfectly marvellous way, often just on the side of a precipice. but it was too much for some of our party, and they insisted upon walking down; and this rather delayed us, as they could not go nearly so fast, nor were they so sure-footed as the ponies. we got in at p.m., very tired and very sunburnt, but having enjoyed the day immensely; and our ponies were quite fresh, and wanted to gallop all the way directly they got on the road. i don't think i have told you about the tree-frogs; they make such a noise after sundown you might think there were thousands of ducks quacking. a gentleman wanted to take some back to england with him; so one day we caught half-a-dozen for him, and they all escaped in our rooms! such a hunt for them! and i could not finish telling you about orotava without one word about the _fleas_. they are really a great trial, and seem to abound everywhere, especially in the carriages. after various false alarms our little steamer, the _fez_ ( tons), arrived, and began to take in a cargo of pumice-stone. the solemn old oxen brought the carros for our baggage, and our many friends escorted us down to the jetty, where most of the spanish population seemed to be collected to see us off. it is always a difficult landing at orotava, and the small ship's-boat gave us a good tossing before we were hauled up the gangway. it was rather horrid before we got away, and i was the only lady who was not sea-sick before the anchor was up! such a change from the _ruapehu_! just one very small saloon, and our cabins very tiny; no upper deck, and very little room on the main deck; of course, no doctor on board, and no stewardess. but it was only for a short time, we thought, and we were determined to make the best of things, and soon found there were compensations--namely, a charming captain, nice crew, and most attentive stewards. and very soon my small deck-chair was established on the bridge, and i learnt more about navigation than i should have learnt in years on a liner. there were twelve of us passengers (all people we knew), and twenty-two officers and crew; also a big dog, and a sheep who occasionally strolled into our cabins, until nearly the end of the voyage, when the meat hung up in the stern (there was no refrigerator on board) had run low, and then one day i saw a sheep's skin being washed over the side! there were also many noisy cocks and hens, and a few ducks; and, last but not least, swarms of rats! i had some sugar-cane in my cabin, and the rats rather fancied it; and when i threw things at them to make them go away, they would sit on the cabin doorstep to wash their faces and lick their lips! we had lovely weather as far as madeira. when we got there we found it was a public holiday, and we should have to stay three days, as there were pipes of wine to be got on board, and the natives would not work on the holiday. this gave us a good opportunity to see the island, and it was very enjoyable. it is far more green than tenerife, but i should say the climate, though very mild, is not nearly so dry. the captain arranged a very nice trip for us to a part of the island that is not often visited by people who call only at funchal. we had to get up in the middle of the night, and go on board a small launch (that takes the mails round the island) at . a.m. it was beautiful moonlight, and funchal looked very pretty as we steamed away round the great loo rock. we reached caliette at a.m., and had to whistle for some time before the people woke up and brought a small boat out for us. they made us some coffee, and we had breakfast, and then got into hammocks slung on long poles; and two men carried us up and up the hills till we came to a weird tunnel, which we went through by the light of pine-torches, and emerged in the most grand scenery--rugged hills and beautiful waterfalls, such very vivid greenery everywhere. and amongst all the semi-tropical vegetation we came upon one bed of english forget-me-nots that was most refreshing. we lunched and rested for some time by a beautiful waterfall, called, i think, "rabacal"; and then going down it was very hot, and, in spite of the steepness of the paths, some of us slept in the hammocks as we jogged along. the men carried us about twenty-five miles in the course of the day, and did not seem at all tired. but there was a little competition to carry me, as i was the lightest of the party! we got back to funchal about p.m., and were quite ready for bed. owing to this delay at madeira (on account of the general holiday) the voyage is taking much longer than usual, and by the time we get in--or hope to get in--we shall be fourteen days out from orotava, instead of the five days we took from london to santa cruz. in consequence of this the provisions are running rather low, and a few things have quite run out; but i have enjoyed the voyage immensely. before i return home, i hope to visit two or three children's hospitals in london, to be interviewed by the matrons, so as to settle where i will go to begin training. i am not old enough for admission to a general hospital yet. iv children's hospital, london, _june _. i thought i would wait till i had been here three months before writing to tell you of my raw probationer days. at first it was all so very new to me that it seemed very, very hard; and i really think that, if it had not been for the fact that one of my brothers had bet me that i should give it up in a fortnight, i should have done so in the first week. but i rarely bet, and when i do, i like to win! and having had to wait so many years before i could persuade a matron that i was old enough and strong enough, i really could not lightly give it up. by the end of my month on trial i began to feel my way, and was quite certain that i wished to stay on if they would keep me; and though they were not enthusiastic in telling me my services were invaluable, their only cause of complaint appeared to be that i was slow. so they were graciously pleased to accept my fifty-two guineas (in instalments), and for that sum to allow me the privilege of working hard and fast for an average of eleven hours a day (paying for my own laundry, and buying my own uniform) for the period of one year. i don't think i was slow in attending to the children; but at first a very large part of one's time is taken up with cleaning and housemaiding--sweeping, dusting, scrubbing, polishing the brass taps and bed-knobs, and washing the children's pinafores and bibs, &c. when i began, i hardly knew the difference between a broom and a scrubbing-brush. i knew nothing of the labour-saving properties of soda and hudson's soap, and i don't think i had ever dusted a room; so i did not know how fond the dust was of collecting on the top of screens and pictures and window-ledges, and it took me time to discover these things. at home our breakfast-hour had always been a.m., and, except for a day's hunting, there were very few things that excited my interest before that hour; so i expected to find it difficult to have had my breakfast and to be ready to go on duty at a.m. but in looking back upon my first week in hospital, the thing that impressed itself upon me more than the trouble of early rising was the fact that during that first month i was always hungry! i have got over the difficulty now, as a weekly parcel of "tuck" arrives from home; and when this comes to an end, i buy some potted-meat or (if funds are low) some plain chocolate to carry on till the next parcel arrives. nearly all the nurses either have food sent, or else buy a good deal. of course i did not know this would be necessary, and had not got money at first. and there are a few nurses who cannot afford to buy, but of course we share with them. dinner is at p.m., and that is the best meal of the day, as the matron sometimes comes to it; so the meat is generally well cooked. it is always a scramble to get lunch some time between ten and twelve, and it is not interesting--just chunks of cold meat, and (every other day) bread-and-treacle. our butter is issued to us twice a week--¼ lb. in a little tin mug--and we have to carry this mug about, for meals in the dining-hall and in the ward kitchen, for as long as it lasts. but if you don't keep a sharp eye on your mug, it often becomes empty in the first day or two, and you stand a good chance of having to eat dry bread for the days before the new butter is put out. i very much dislike coffee; but there is nothing else provided for breakfast but coffee and a loaf of stale bread, and our own butter (if we have any left), so we don't seem to start the day very well. for the rest, we make tea twice a day in the ward kitchens, and can use the ward bread. if funds are high and the lunch bad, we sometimes indulge in rashers of bacon; sometimes on sunday we have a sausage or two; but it is more usual to fill in the cracks with tea and cake. up to now i have been working in a medical ward of twenty-one cots. the sister has charge of a surgical ward as well, and i think she prefers the surgical work; so we don't see very much of her, except when the physicians go round, or when we have very bad cases in. i like her very well, but she is rather stiff; and most of the information i am picking up is from the staff nurse and from the house physician, who is most kind in explaining the reasons for the various symptoms we notice in the cases, and what results he hopes for in the treatment he prescribes. we had a very sad case in the other day. a working man brought in a little chap of two, called stanley, very ill with pneumonia and rickets. he said his wife was in another hospital (for an operation), and he had to go to work and leave all his children in charge of the eldest, a boy of ten; and his wife had been so very ill he had had to go to see her in the evenings, and so had not noticed how ill stanley was. at first he kept holding out his arms to me, and calling in such a piteous little voice, "lady, lady"; but he soon got quite contented, only every day weaker and weaker. his quiet, patient father came every evening and sat by him, and his mother was to come to see him as soon as ever she was well enough; but the poor woman was too late, and when early one morning she arrived in a cab with a nurse from the hospital, he had just been carried down to the mortuary, and we could only take her to see him lying there, looking very sweet, with some white lilies in his hand. then we have dear philip in. he is tubercular, and _such_ a pretty boy; but i think he is too good to live. i am afraid his mother drinks, and he has a rough time of it at home; but his father is a very nice man. here we all spoil him, as he is really very ill, but is always so patient and bright. he has a mop of brown curls and the smile of an angel. he is one of the few children of the slums who always insists upon kneeling up to say his prayers; and though sometimes he has so little breath to spare that i have to say the words for him, he just kneels there and smiles when i get hold of the words he wants to help him out. as a contrast, another of my patients was samuel abraham, the very ugliest little scrap of skin and bones you ever saw. when he came in he was seven months old, and weighed only eight pounds. he was in for six weeks, and absolutely refused to put on a single ounce. then every one got tired of samuel, and as i had not had a turn at feeding him, he was handed over to me; and, more by good luck than by good management, he began to improve, and at the end of my first week he had put on six ounces, and since then he has steadily gained in weight, and begins to look more like a baby than a monkey. he went home the other day, and i wonder much whether his poor mother will be able to rear him, as i am sure he will miss the hourly attention he has had here. we should have kept him longer; but we had three cases of scarlet fever, and they had to be sent to the fever hospital, and all the children who could be moved had to go home, and the ward will be sulphured. but i am writing this letter as i sit in the bare ward beside one poor little boy called jackie, who is so desperately ill with meningitis that they don't like to move him. it is a curious case. jackie belongs to well-to-do people, and his illness was caused by a fall out of a mail-cart. his head is so retracted that it really nearly touches his buttocks, and he lies in a stiff backward bow. he is quite unconscious, and i have to feed him with a nasal tube; his temperature goes up to and . at first i was rather nervous at being "special" with him, as i have been here only three months, and i have never seen a case like this before; and the sister may not come in to see me, as she has to go into the surgical ward, and we may still be infectious. but of course i can ask her advice about anything, and the house physician comes in twice a day, and is most kind. he assures me no one could possibly do more for jackie than i am doing. i think he will be moved to a small ward to-morrow (if he lives so long), and then i expect i shall have to disinfect, and very likely go to a surgical ward. v children's hospital, london, _november _. i know it is a long time since my last letter to you, but really the days are so full of work there seems to be no peace for letters; and at night one is so weary that, after a wrestle to obtain a bath, one feels fit for nothing but bed. and when i get to bed i feel obliged to take my anatomy and physiology books and do a little study, as the residents are very good about giving us lectures, and i should hate not to do decently in the exams. i think when i last wrote we had just closed the medical ward (whose sister had had the honour of beginning my hospital education), and after a few hours off duty i was sent up to a surgical ward on the top floor, next door to the theatre. i went up rather in fear and trembling, as it was noted for being the hardest ward in the hospital--as the nurses were responsible for the theatre as well--and i didn't see how i could squeeze more work into the days than i had been doing on the medical side. but i received a nice welcome from the sister, and soon found that she was one of the best. she didn't wait for us to do things wrong, and then scold us; but she took pains to show us the _best_ way to do them, and then woe betide those who didn't do their best! i shall always remember my second morning up there, when she said, "nurse, your bathroom looks very smart and nice." it was the first time a sister had given me a word of praise, and from that day i didn't mind how hard i worked to please her. there was a different atmosphere about that ward, and i soon felt better in it. the children, too, were a more cheery set. some of them were very ill; but we did not get the poor little "wasting" babies, and it was very seldom we had a child who minded a noise, so that the boys (at certain hours of the day) could be allowed to sing all the popular songs of the day; and they were a very merry crew. many people think it must be very depressing to see so many sick children; but, as a matter of fact, the children have very little pain--or, at any rate, only for a very short time--and many of them are enjoying a better time than they have had in their lives before. they are kept clean and warm, and have plenty of good food and plenty of toys to play with, and people who understand them when they have a pain, even when they can't explain where it is. there have been many changes since i came here. several nurses who came after i did have already left, and one has gone away ill. i had been in the surgical ward only a fortnight when i was unlucky enough to pick up influenza, and was sent to bed, with another nurse, in a small quarantine-room up above the measles ward. they were rather suspicious as to whether we had scarlet fever, as there was still some in the hospital; so no one was supposed to visit us except the home sister. her visits were few and far between. poor thing, she was stout, and the stairs were many! we both felt pretty bad with high temperatures, and should have come off badly for attention if it had not been for the "measles nurse," who had only two convalescent children, and she used to break the rules and come up to look after us. one day she had run up with an offering of buttered toast, when we heard a door open downstairs, and _felt_ that the matron was coming. nurse vanished into our little kitchen-pantry; but there was no escape from that without passing our wide-open door, and, besides, the matron was sure to call upon the measles ward on her way downstairs. the buttered toast was stowed away under the bed-clothes, and we were trying to be calm and answer matron's enquiries as to our health, when we heard a rattling of the hand-lift on which our food was sent up from the kitchen, and we realised that nurse had determined to crawl into that, and so descend to her post of duty. with much alarm we heard the lift go down, and trembled lest the unaccustomed weight should cause it to go down with a run. matron must have thought us very distrait; but we pleaded severe headaches--a plea that was true enough--and she soon went away, "hoping we should shortly be fit for duty again." we were very thankful when nurse appeared to report her safety, with nothing worse than a crushed cap and a crumpled apron, which had been severely commented upon by the matron. they were short of nurses, so as soon as i could get about i went on duty again, and had a nice welcome back to my ward. but it happened to be very heavy just then with several small babies, and two of them had hare-lips that had been operated upon, and it was most important that they should not be allowed to cry at all. so one evening i was sitting in the ward cleaning some instruments that had been used in the theatre for a nasty case of mastoid abscess, and one of these babies began to whimper. i jumped up to subdue it, and in doing so i had the bad luck to prick my thumb. the baby soon settled down again, and then sister came in and cleaned and dressed my thumb; but in a few days i was in for a badly poisoned hand, and it had to be opened in several places by the house surgeon. he wanted me to be off duty, and out-of-doors as much as possible; so sister arranged to give me some extra off-duty time, and was awfully kind in doing part of my work for me. but when she told matron about it, matron said, "nurse has been off duty over a week with influenza. if she has to go off again, she had better go home and stop there, as she is not strong enough for the work." but sister didn't want me to go, and fortunately the ward was getting lighter, and i could keep the babies quiet even with my arm in a sling; so i did what i could, and was sent into the kitchen when the visiting surgeon went round, lest he should order me away. the house surgeon was furious with the matron about it, but he looked after me well, and though my arm was very painful for a fortnight, and allowed me very little sleep, it soon improved. but my thumb is still stiff and unbendable, and the house surgeon is afraid it will always be so, as he had to cut into it so deeply. i must tell you about a quaint child we had in about that time. she was a little irish girl called kathleen, with a mop of red hair and a pretty little face, but with very crossed eyes. kathleen was five years old, but had never walked, as her legs were badly deformed; but she got about at a great pace on the floor in a style of her own invention. you never quite knew where you were with kathleen. she had a very sharp temper; but she was devoted to sister, and was obedient to me. but any directions given to her as to her behaviour by other nurses were received with scorn and entirely ignored; and if sister and i happened to be off duty together, on our return we generally had to remonstrate with the child for some piece of naughtiness, and then she would soon be sobbing and penitent. one day i was off in the afternoon, and when tea-time came kathleen was missing. they searched everywhere for her; and matron, who happened to pass, joined in the search. eventually she was found shut up in the sisters' dining hall, very much engaged with the food-cupboard. the butter had all gone, so had most of the sugar, some of the biscuits, and, when discovered, she was just drinking up the vinegar with relish. matron remarked, "a good toffee mixture!" and then she spent half-an-hour trying to make the child say she was sorry, but without success; so she smacked her, and sent her to bed! on my return, of course, i had an account of kathleen's misdoings, and thought it better to take no notice of her. all the evening as i did my work the little white-faced thing sat up in her cot watching me go up and down the ward, with her poor crooked eyes quite dry; but when the children were all settled for the night and the lights turned down, i went to her, and she flung her arms round my neck and sobbed out, "i _am_ sorry, and i won't do it never no more. but i wasn't sorry to that woman, and i don't care if she does smack me; but i shall tell my mother when i go home." then i lifted her out of her cot to warm her toes by the fire, and after a long talk i extracted a promise that she would tell matron she was sorry next day; and in a very few minutes she was fast asleep. i expect that i shall be moved from this ward very soon, and i shall be very sorry. the work is hard and fast, but sister works as hard as we do; so we are very happy together, and i feel i am getting on. i have got used to the theatre work too, and (after much labour) have learnt the names of all the instruments in common use, so that i can hand them as they are asked for; and sometimes i am trusted to put out what i think will be required for an operation, and when sister looks them over she doesn't often find anything missing. vi children's hospital, london, _march _. soon after i last wrote i was sent down to the out-patients' department--quite a different kind of work, and i shouldn't like it for long, but it was interesting for a time. the numbers vary a great deal. from fifty to a hundred children may be brought up in one day, and many of them require small dressings to be attended to. then, on two afternoons in the week, the surgeons do small operations; and sometimes there are half-a-dozen children all recovering from anæsthetics at the same time, and all requiring to be carefully watched. there is a dear old sister in charge, and one afternoon a week we go out together to visit any special hip cases that are being treated in their own homes, after having been in-patients here. _such_ slums we sometimes have to go to; and yet it is wonderful how nicely the poor mothers keep these children when they are just shown the right way. we have one jolly little chap, who has been for two months in an extension apparatus rigged up on a big perambulator, with the weight hanging over the handle. he has improved so much that they will soon wheel him up in his bed-carriage, and i think the doctor will then sign his release from the extension. some of the nurses had rather a joke the other day--a joke which had good results for the rest of us. there is a confectioner's shop near here which we largely patronise, and these girls who were on night duty were hungry as usual, and they went into this shop for tea and scones before going to bed. while they were there, our secretary superintendent came in; and afterwards mrs. ---- (who is quite a friend of ours) told the nurses that, seeing them there, he asked her whether many nurses were customers of hers; and she, pretending not to know him, said, "oh yes, sir; but we gets more nurses from the children's hospital than from any of the other hospitals round here. you see, they feeds them _that_ badly there!" i believe he went straight back to the hospital and made inquiries about our food, for not many days after we had bacon for breakfast; and now there is always _something_ besides the bread put on the table, and we find it a vast improvement. another thing has happened which has helped us considerably. a new nurse has joined, who is a cousin of the senior surgeon. she is an awfully nice girl, but does not look very strong, and after a week or two she retired to bed with a strained back (not very bad). then her cousin visited her, and then he visited the committee; and it seems they had no idea we had to carry all the big lotion bottles up from the dispensary, and the heavy blocks of ice from the basement, and that we had to drag down the great bags of soiled linen to the basement and then along a lengthy passage--no joke on the doctor's day, when all the twenty cots have clean sheets and counterpanes, &c. so now the porters do these things for us, and we mournfully regret that we were not clever enough to arrange for one of our number to strain her back at the beginning of our training, instead of nearly at the end; but without a senior surgeon for a cousin it might not have paid! nurse is nearly well again now, and she has asked me to spend part of my next free sunday with her at the house of this same senior surgeon. i shall be horribly shy, but i can't well refuse. my brother h. has come to live in town now, and it is very nice for me. he is reading for an exam., and has rooms in barnard's inn--such a funny old rookery near holborn, and not far from here. he stands me a good dinner about once a week, when i am off in the evening; and in return i darn his socks for him, try to take him to church on sundays, and report his doings in my letters home, so that he need only send them occasional post-cards! while i was in the out-patient department i was supposed to have my sundays free, unless an "extra" was especially wanted anywhere; and one saturday evening i was preparing to go away for the night, when a message came that the night sister was not well, and matron (who was going away till monday) wished me to go on duty for her for the two nights. that was about p.m.; so i went to lie down for a bit, and at p.m. the home sister gave me the report and the hospital keys, and i took charge, feeling rather important, but also rather a fraud, as several of the charge nurses then on night duty had been here for many years, and knew far more than i did. however, we got on very well together, and i rather enjoyed running round to the different wards, and helping with the bad cases. there was one especially sad case--a girl of ten who had been frightened by rats when left locked up in a house. she had chorea so badly that we had to let her sleep on a mattress on the floor, and it was most difficult to keep any clothes on her, or to feed her. poor child, her temperature gradually rose till it reached . before she died, a few days later. the doctors said it was the worst case they had ever seen, and i hope i may never see another case die of chorea. on the monday morning i went to bed at a.m., and had to be on duty in the out-patient department at a.m. we had a heavy day; and when we finished at . p.m., you can imagine my disgust at receiving a message from matron that i was to relieve the nurse who was in quarantine with a whooping-cough case, from to p.m. i was very glad the child whooped fairly often, as otherwise i should probably have gone to sleep. the next morning i _did_ over-sleep, and was ten minutes late for breakfast, thereby incurring a lecture from the matron; but i could not refrain from remarking to her that i had had only two hours' sleep since sunday (until that night), and she said, "what _do_ you mean, nurse?" and then it came out that when she sent me to quarantine she had quite forgotten that i had been on night-duty for those two nights, but i had to relieve in quarantine again that night in spite of it. of course none of us ever mind doing extra duty when it is necessary, but there were plenty of others who might have done it, and got their full amount of off-duty time as well. since then i have been working in several different wards, and there are so many new nurses who have come since i did, that i am generally first probationer now, and it is far more interesting, and when the staff nurse is off duty, i take her place. matron has been quite civil to me lately, so i suppose my reports have been all right, as i believe she disliked me very much at first, and did not take much trouble not to show it. just now i am again in the out-patient department, as sister has been called home on account of illness, and i am working it with another probationer, and with no sister. the other probationer is two weeks senior to me, but she has not been down in the out-patients before, so we are not quite clear which of us is in command; at present i make her take the lead on medical days, and i do on the surgical days, as i am more used to the surgeons and their ways; and we get along very well. i shall very soon have finished my year here, and have been very much exercised over the question of what i had better do next. one of the sisters that i have liked here has been appointed matron of a small children's hospital, and she has offered me a post as staff nurse. this was very kind of her; but, on the whole, i think i would rather get my adult training before i do anything else, as i am afraid it would be rather hard to begin at the beginning again, if i went on to being a staff nurse with children. the matron advises me to take a good long rest before beginning in an adult hospital, as i have got very thin and run down of late, and i am still a year too young to be received at the best hospitals; so it is just possible i may accept an invitation from my eldest brother to go out to him for a year in south africa. in the meantime, i am gathering all information about the london hospitals, and am to visit two or three of them for interviews with the matrons before i leave here. i have passed my exams. all right, so my first certificate is fairly safe. for many reasons i shall be very sorry to leave here, but oh! i am so tired, and to think of being able to stay in bed till i feel i want to get up, is a joy indeed. vii kimberley, south africa, _july _. when i last wrote to you i was still a humble pro., often a weary, hungry, and foot-sore pro., but withal a happy one, and i hope one day to be a pro. again--but for the present, times have changed. i have come out to stay with my brother, who is the judge-president here. he has lived here for the last eleven or twelve years, but this year there is a great exhibition in kimberley, so he has taken a larger house for the time being, and will be able to entertain a few friends who will be coming up for the exhibition. i left southampton in june, on the r.m.s. _scot_, and had a very pleasant voyage out in good weather. i suppose people are always especially kind to a "lone lady" on board ship; at any rate, i had a very good time. there were not many passengers on board, only forty-two gentlemen in the first class, and seventeen ladies, so i had a nice big cabin to myself. the _scot_ is the only twin-screw steamer on that line, and it was lucky she had a twin screw, as, when i woke up the first morning out from southampton, there was a strange silence on board, and when i got on deck i found there had been an explosion in the engine-room, and the top of the high-pressure valve was blown off; there was some talk of having to signal for a steamer to tow us into brest, but after awhile, the engineers concluded they could patch up matters, and we could proceed with one screw working; this reduced our speed, but i did not mind that at all. the bay behaved very nicely, and i did not miss a meal in the saloon all the way out. we had a few hours ashore at madeira while they were coaling and overhauling the damaged machinery, and the flowers and fruit were beautiful as ever; the men and boys swarmed round the steamer in little boats, and would dive into the sea for silver coins thrown overboard: one or two of them could dive down under our ship and come up on the other side. the next day we passed the canary islands, and had a good view of my old friend, the peak of tenerife. we had the usual board-ship entertainments; two dances (the stewards make a very good band), several concerts, an amusing "trial by jury" of one of the passengers, sports for the passengers and for the crew, plenty of cricket and other games. this is the programme for one day from my diary:-- seven a.m.: salt tub. . : on deck, tramp and talk, and then read. . : breakfast; excitement over the sweepstakes on the ship's run, &c.; read, prepare programmes for the concert at night, hunt up people to sing, &c.; watch a whale and flying-fish. . : fire and boat drill by the crew. p.m.: lunch, sleep. : play cricket. : tea, choir practice, tramp and talk. . : dinner. . : concert, tramp and talk and watch the phosphorescence, and look for the southern cross till p.m.; then bed, and as sound a sleep as though i had done a day's work. a sea-voyage, with pleasant people on board, and not too rough a sea, is the most restful way of taking a holiday i can imagine. it was very damp and hot crossing the line, and the cabins became so stuffy that sleep at night was somewhat difficult; but one could make up for that by sleeping a few hours in the day when up on deck. all too soon we anchored in table bay, under the shelter of table mountain. many people are disappointed in their first view of table mountain, but it has a grandeur all its own, and it grows upon you. my brother was unable to meet me as he had intended, but a friend of his came on board--a gentleman who was down in cape town for the session of parliament--and i found it was arranged for me to spend a day or two with him and his family at sea point, a suburb of cape town, before continuing my journey "up country." having come nearly miles alone, it did not seem to make a great deal of odds having to do another miles alone; but i was glad of a few days' rest, with pleasant people. i had made so many friends on board the ship that it was quite sad to say good-bye to them all; and i had more than one kind invitation to stay with people in different parts of south africa. the day after we landed, i was taken to hear a debate in the house of parliament on the deceased wife's sister's bill. the people i was staying with went on to a reception at government house, and wanted to take me with them; but i begged off, not having unpacked suitable garments. it is very pretty all round cape town, and i hope to see more of it before i return home. then, one evening at p.m., i was seen off from cape town station, and was once more a traveller on my own account, but not under such comfortable conditions as on board ship. i learnt that the dining and sleeping cars were attached to the trains only on one night of the week (the night the mail-boats come in), so i went in an ordinary first-class carriage, the ticket costing me more than £ , and found the seats were covered with horse-hair, and by no means comfortable for a night journey. above the seat there is a shelf which lets down at night, so that four people can secure lying-down room in each carriage. i soon learnt, also, that in this upside-down country, in spite of the fact that it was the month of july, it was also the middle of winter, and as we got up to higher altitudes it became intensely cold. i had the carriage to myself at first, and, having piled on all the clothes i had with me, i was trying to sleep, when, about a.m., two old dutch ladies were put in with me, and for the rest of the night they chattered, and ate cheese and apples and onions, so that sleep was impossible until they left the train at matjesfontein. i am told the scenery we passed through that night is very grand. i hope some time to see it under more favourable conditions. cold and hungry, about a.m., we stopped for breakfast at matjesfontein. i took my sponge-bag and towel, thinking i should find a waiting-room; but all i found was a tap on the platform, where we took our turn at a splash in icy-cold water, and then went on to a tin shanty, where breakfast was served--kippers, good bread, indifferent butter, and moderate tea. there did not seem to be any hurry; but when we had all finished, and the engine had had a drink, and the engine-driver had lit his pipe, we started off again. and all that day we strolled across the karroo, stopping (apparently) just when the driver felt inclined, and, when there was a hill, going so slowly one felt tempted to jump off and take a little exercise by running alongside. it was very grey and brown, this wonderful karroo country, with occasional kopjes (hills with great boulders of stones up the sides), and now and then a river or a stream, and always by any water a green line of the mimosa trees covered with their yellow flower. as the sun grew stronger i began to forget the discomforts of the night, and some pleasant dutch people came on board and told me many interesting things about the country we were passing through. then i was introduced to my first swarm of locusts; a weird sight it was, too. they were pointed out to me first when they were some miles ahead of us, and looked like a small black cloud; then, as they came near, the sky seemed to become black with them, and we had to shut all the windows or the carriage would soon have been full of them. they tell me sometimes the young ones settle on the lines in such masses, and the lines become so slippery, the trains can't get on, and the men have to turn out and shovel them off. fancy a great northern express being held up by a swarm of locusts! for most of the way the old waggon-road ran alongside the railway, and was marked out by the skeletons of horses and oxen, or the sadder sight of a mound of stones with a little wooden cross, where some poor fellow had "fallen by the way." we stopped at victoria west for dinner; and as there was another train (from up country) in the station, we were halted well out on the veldt, and i had to stumble along to the station, and then, across what seemed in the darkness to be a rickyard, to the tin shanty where dinner was served. i was the only lady there; but i had only had a snack lunch on board the train, and we were more than an hour later than we had expected to dine, so i was too hungry to mind much, and had a very good dinner. there is only a single line for all this long track, so the delays to allow trains to pass at the stations are numerous, and it is well never to travel without a supply of chocolate, as the meals are very movable feasts. i managed to sleep through that night, as it was not so cold, and i had the carriage to myself. early the next morning we steamed into kimberley, and my brother met me at the station. viii kimberley, south africa, _december _. two things are prominent in my mind to-day: the first is that the thermometer is at ° in the shade, and the mosquitoes are perfectly vicious; and the second is that the kimberley exhibition, with its round of gaieties, is actually closed. but before i tell you about this exhibition, i must try to go back and give you a few "first impressions" of the diamond fields. as you come into kimberley by train, you first pass the kaffir location; and, instead of the picturesque dwellings that one sees in pictures, you see an exceedingly untidy collection of huts built of all sorts of odds and ends--bits of galvanized iron, old paraffin tins, &c. then come small tin shanties inhabited by the "poor whites"; and so the houses improve, as one nears the centre of the town. we drove down from the station in a cape cart, which takes the place of a fly here. it is a comfortable kind of dog-cart with two wheels, drawn by a pair of horses; it has a movable hood, and the four passengers all sit facing the horse's tail. the most comfortable seats are at the back, and part of the driver's seat lifts up on a hinge while you get to the back seat. i found my brother had taken a house and bought all the furniture in it, so there was not much difficulty about settling in, except hanging our own pictures and buying a little more linen, plate, &c. it was a nice brick-walled bungalow, with the usual galvanized-iron roof, and a shady balcony (called here a stoep) all the way round the house, so that one could generally find a fairly cool place to sit. he had also secured a very good white woman as cook, and a dusky zulu called george, who waited at table, and generally fagged for the cook. george looked about fifteen, so i treated him as i would a boy of eleven or twelve, and he was soon my most devoted slave. but one day i asked him how old he was, and he said, "i was thirty-four last census, missus." but i shall continue to treat him in the same way, as it seems to answer well; and, after all, i think these blacks will always be rather like children, however old they are. i find he has a wife at a kraal, up country, and he is now saving up to buy some cows wherewith to secure another wife. i understand the present value of "a nice kaffir girl" is seven cows! there is a large compound at the back of the house; and thrown in with the house we found two dogs, a dignified cat, and some fowls and turkeys. at first i thought the kimberley people were rather uninteresting, and felt inclined to agree with the barber who, when he was giving me a most refreshing and much-needed shampoo after the dusty journey up, said, "you _will_ think the ladies here funny, miss, for they absolutely never talk about anything but their dresses"; but, poor things, there was very little else to talk about. every one was kind in coming to call, and i soon found some very nice people amongst them. sunday is the great day for all the gentlemen to call; and sometimes we had eight or nine men dropping in on sunday afternoon, and generally one or two came in to supper after church. there is a splendid library nearly opposite the club (which is also a fine building), and i very much appreciate the cool reading-room, with all the english papers and magazines, only about a month old. we play a good deal of tennis on gravel courts. there are two days in the week when ladies can play at the club, and some people who have private courts have regular "days," so that i generally play three or four afternoons a week. just lately i have had some good riding, as a young lady i know has gone down to the cape, and has left a nice and young horse behind. her mother offered to lend it to me one day, and i had a glorious gallop over the veldt with their groom; and then a kind note came, saying that "i was doing them a great favour by exercising the horse, as it was too fresh for the younger girls." i am glad to be able to do a favour so easily, and we make up very pleasant little riding parties. i think the thing one misses most in kimberley is water. if you ride or drive, you may find some out at the waterworks or (a variable amount) in the river out at alexanderfontein, but the water you can find within walking distance might be measured in bucketsful; and the men are fond of talking of the "early days," when it was cheaper to have a bath in soda-water than in plain water, and of a notice that was said to have been put up in a hotel, "please do not use soap, as the water is required for tea." in the season, with careful watering, one can grow a good many flowers. roses do especially well, and some people who are diligent with the watering-pot cultivate a small piece of grass; but a few days' neglect, or a few hours' visitation from a flight of locusts, and your treasured piece of grass is as though a prairie fire had been over it. of course there was much excitement up here about the opening of the exhibition. the governor and family came up from cape town for the ceremony, and stayed nearly a fortnight in mr. c.'s house--which he gave up to them--and there was much entertaining. we had the colonial secretary and his wife staying with us, and also a daughter of the governor of bechuanaland. as mr. ---- was the minister in attendance on the governor, he had to bring his secretary with him, and the police superintendent posted a mounted orderly at our gate to take his messages about; so we felt quite important. many interesting people from all over south africa came up for the exhibition, and i am afraid i shan't be able to remember all those to whom i have been introduced. mr. cecil rhodes was here for a few days, and we went to supper with him one sunday evening. he is generally supposed to dislike ladies; but if that is true, he does not show it. there were not many there, and i sat next to him at supper. i believe it was a very good supper; but the conversation was so interesting (all about south africa and south africans) i couldn't attend to it, and i went home hungry, and had to have a private snack before i went to bed. the morning after the governor arrived we received an invitation to dine at government house that evening; and it was rather awkward, as we had a dinner party here. but p. and mr. ---- went off to call and explain matters, and we were excused. they gave two huge garden parties, which we attended, and i enjoyed them very much--both the governor and lady so very pleasant and friendly. another day they were the guests of de beers, and we also were invited; so we saw all the process of diamond-mining under very comfortable circumstances: the blue stone as it was brought up from the mines in little trucks and laid out in the sun (surrounded by barbed-wire fences) to pulverize, then collected and crushed and washed; and then we went into the sorting-shed, and were given trowels to sort with, and i found four nice diamonds in ten minutes, and should like to have kept them! then to the packing-room, and saw _such_ diamonds, bags and bags of them. afterwards we drove out to kenilworth, the model village, all planned by mr. cecil rhodes for the de beers' men. such nice little houses, with water laid on, and every convenience; a good garden to each house; a school and a club-house; a recreation ground; and then miles of fruit-trees--grapes, peaches, apricots, &c.--that mr. rhodes has planted and has had carefully irrigated. one could hardly believe it was so near to kimberley, and kimberley dust. every day at the exhibition there was a good band playing, and every evening some fireworks and other entertainments. cricket matches--played on a pitch of cocoanut matting--tennis tournaments, &c., were the order of the day; so that now, when the governor and other visitors have returned to the cape, and the exhibition is closed, you can understand that kimberley seems a little flat, and i am much looking forward to a run down to the cape next month by way of a change. ix kenilworth, nr. cape town, _january _. here we are, amidst lovely greenery and flowers, with the turtle-doves cooing in the garden, and with the very blue sea on one side and grand old table mountain towering above us on the other. kimberley was really a very warm place before we left it. we had had several bad dust-storms, when you shut up all the doors and windows, and still the dust comes through, and settles in inches on the furniture, and everything you touch or taste is dusty. one of the worst dust-storms, and the hottest of days, was christmas day. we had invited a few lonely men to dinner; and when i came in to dress, george met me at the door, and said, "missus, kitchen window all gone; dinner no good." and when i went to investigate, i found poor stanley nearly weeping, as the window had been blown completely in, frame and all, on to the table at which she was preparing our dinner; and the dignified cat was licking up the custard on the floor! fortunately the turkey was saved, and, with the help of a few extra tins, we scraped together a fairly good dinner. i don't know what would become of the people in kimberley if they were afraid to eat tinned foods. besides the dust (and my old enemies, the mosquitoes), the flies were very horrible. they settle everywhere, and it is necessary to keep everything very well covered up. you have to shoo them off the sugar before you help yourself; and if you venture to put some honey or jam on your bread, it is ten to one there is at least one fly on it before it reaches your mouth! well, we left kimberley still gasping for rain, and the train strolled down to the cape in two days and one night. the scenery we passed through on the second day was very fine indeed, all through the hex river pass. i saw a good many baboons. one little chap scuttled away, and then sat down and threw stones at us. a most quaint little beast he looked, in a fury of a temper. mr. ---- met us at the station, and they have such a delightful house and garden. you have no idea what a rest it is to see plenty of greenery again, after all the sun and glare of kimberley. all the people about here seem to be so very pleasant and friendly, i am enjoying myself immensely. we went to dinner one night at government house. i was shy at the prospect of going, but it was really very jolly. i went in to dinner with captain ---- of h.m.s. ---- (now at simonstown), and he was very entertaining. the men were all in naval, military, or court dress, and they looked so nice. another day mrs. ---- gave a picnic at constantia, the government wine farm, and the governor and party joined us there. it was a very pretty place, and after tea we went for a scramble up a ravine to pick blackberries. part of the way up i was trying to disentangle lady ---- from a bramble, when the governor turned round and called to her, "hurry up, my dear, hurry up!" and she replied, "but, h. dear, i'm caught by my hair." so he had to return to assist; and then coming down he twice fell down, and each time pretended he had sat down only to admire the view! on sunday we went over to simonstown to call on the admiral's wife. there were two captains of men-of-war calling, and some other officers, and they invited us to visit them on their ships; but p. could not spare a day. i was rather disappointed. mr. cecil rhodes was away, but we walked over to see his place, groot schuur. it is a very lovely and peaceful spot, just at the foot of table mountain, and with lovely views in all directions. the hydrangeas that he is so fond of are quite a sight; they grow up the sides of a hollow glen in the grounds, and the mass of different shades is very beautiful. another day we went to lunch with the chief justice at wynberg. such a lovely place he has, with many beautiful trees in the grounds. amongst others they have a good many of the silver trees which grow up table mountain, and, i believe, nowhere else in the world. in the afternoon lady ---- drove us to a huge garden party at newlands (government house). i heard that invitations had been sent out, and i should think most of them had been accepted. but there was still plenty of room, and the grounds are beautiful; and there was a good band playing. one of khama's sons was there, but i did not meet him. my brother was anxious to have a little sea-bathing, so we stayed for a few days at a small place called muizenberg, on the shore of false bay. i have never bathed in such deliciously warm water before. i believe there are some sharks around table bay, but false bay is considered quite safe; so many cape town people go out there to bathe, and some of them have bungalows near the sea. i was very keen to climb table mountain, so i left p. for one night at muizenberg, and went to spend the night again at kenilworth, with some friends who were making up a "mountain party." we were up early, and left in cape carts--a party of eight--at a.m., and drove round to hout's bay neck. most unfortunately it was a cloudy morning, and the mountain is said to be dangerous in a fog; but we kept hoping it would clear, and we began the climb at . a.m. it was fairly steep, but never really a difficult climb. when we got to the ranger's cottage, we found he had just killed a horrid cobra snake that measured feet inches long. he did not hold out any hope of the weather clearing; but as we had gone so far, we thought we might as well go on. so we clambered to the top, where we arrived at a.m., and were greatly disappointed not to get any view. the only compensations were the flowers we found, which were simply lovely--huge white heather, and many-coloured everlastings, and many flowers which i had never seen before. coming down in the afternoon, it was blowing and cold, and at one place we missed the path, and for about a mile had to force our way through some thick and very wet undergrowth, and then it began to rain. so we were rather a draggled-looking party when we reached the carts, and the drive home in our wet garments was not exactly comfortable. this may not sound as though we had a very enjoyable expedition, and yet i really did enjoy the day very much. the people were all so jolly, and made fun of all the discomforts. major ----, the governor's secretary, was one of the party, and he had provided himself with pins, needles, bandages, sticking plaster, and all sorts of other things, most of which came in useful in the course of the day. i heard afterwards that he told the governor that he had never done such a hard day's work before, as we made him walk for eleven and a half hours, and only let him sit down for half an hour! the time has gone so quickly down here, as there has been so much going on, and every one has been so kind. we have had about twice as many invitations as we could accept. now we are packing up to return to kimberley, and as they have had some good rains up there, i hope we shall find it a little cooled down. if only we could take some of this lovely greenery with us! you have no idea how grateful you ought to be in england that you can always find a green field if you go to look for it, instead of perpetual greyness and brownness and glare. soon after we get back p. will have to start off on circuit in the colony, and i am hoping to go part of the way with him, and then to start off on an expedition to visit some friends up country in natal; they are fifty miles from a railway. i am looking forward to this tremendously. and then soon after it will be time for me to make tracks for home, as i have now nearly reached the venerable age of twenty-three, and am therefore eligible for beginning my training in an adult hospital. and though this sort of life is very jolly for a time, i should not like it for always; it is not so satisfying as useful work. i am quite sad at saying good-bye to all my friends. i believe one makes real friends more easily out here than one does in england. it must be something in the air. x greytown, natal, _april _. after my last letter to you we journeyed back, over the seven hundred odd miles to kimberley, and found life up there a little flat after the gay time we had been having at the cape; but i had some good tennis and riding, and then we had to prepare for the circuit. at each place that the judge visits he has to do a little entertaining, so he has to take a cook and a butler with him; and as some of the places where courts are held are quite villages, he has to take a certain amount of groceries along too--and, of course, wine. the government provide a saloon carriage with a small kitchen on board, so that is used as the judge's headquarters when near the railway lines; but many of the places visited entail long drives in cape carts. the first place we went to was colesberg, and we arrived there at a.m. we were quite a large party with the barristers, the clerk and registrar, the interpreter, and the servants. we were met by the magistrate and the sheriff, with a smart escort of cape mounted police, and a party of convicts to take the baggage up. we found a nice little house ready for us, the owner having turned out to make room; and, after a wash and breakfast, the men all went off to the court, and i stayed to unpack and get things straight. there were three coloured girls left to do the housework, &c. none of them could speak english, and they had several babies scattered about. i knew we had to give a dinner party before we left, and felt rather hopeless about how it would go with the material to hand. however, everything went off very well in the end. lots of people called on me, and i had some good tennis at the club, and also some nice rides on a horse that was lent to me, the first one i have tried since i came to this country that had a good mouth; most of them are ruined with the bits they use. the surrounding country was rather pretty, and good for corn and cattle. we stayed four days at colesberg, and then moved on to craddock, ten hours on the railway. there was a lot of court work there, and it had to be fitted into five days; so the men were in court nearly all the time--one night up to p.m.--and i found it a little slow. but i had some nice drives, one day going out to see some curious sulphur baths, and another day to a farm about eight miles off, where every imaginable kind of fruit seemed to grow. after this we parted company, my brother going on to middleburg, and i for another run of ten hours in the train to port elizabeth, where i joined the _drummond castle_ for durban. various people seemed to have asked the captain to take care of me, so i sat next to him at table, and he was most kind. when he found that i meant to put up at a hotel in durban, he told me that he wouldn't let me do that, as he had lots of friends there, and i should have a much better time if i went to stay with them. we got to east london next day. the sea was rather rough, and there was a lot of cargo to get on board, so we were there some time; but i didn't go ashore. when we had again got under way, the captain came up to me and said, "i have wired to some people in durban to ask them to meet you when we get there." was it not kind of him? when we reached durban i waited till the captain was ready to go ashore; and then we got into a kind of huge clothes-basket, and were swung over the side and into the tender, as these big steamers can't get into the harbour. and when we had come alongside the wharf, we found two ladies waiting for us, with a sweet pair of cream-coloured ponies. they assured me it was quite all right, and that they really had lots of room, and the captain was to come up to lunch. so off we drove to such a nice house up on the berea, with a lovely view right over the harbour. they were very pleasant scotch people, and they _were_ so kind to me, driving me about to see the town, &c. i stayed the night with them, and all the next day, as there was no train till p.m.; and then they saw me off, and made me promise to visit them on my way back. i got to pietermaritzburg at . p.m. (i believe it is very fine scenery on the way up, but it was too dark to see it), and stayed a night at a hotel, where i found that my kind durban friends had wired to the proprietress to look after me; so everything was very comfortable. i was up early the next morning to have a look round maritzburg, and made friends with the driver of the post-cart, who promised me the box-seat. "john" was quite a character, and he entertained me well for all the forty-five miles we drove that day. we got away at . a.m. with six tough little horses and the funniest old noah's ark of a coach you ever saw. the road was very rough, and there were very steep bits down to rivers (or "spruits," as they are called here), and then a hard pull up the other side. we changed horses several times, and some of the teams were very raw and wild; and the leaders were sometimes inclined to turn round and come to see how the shaft-horses were getting on. so john had to use his huge whip at times, and i had to cling on, and i got so bumped about that i was stiff for days afterwards. john had many interesting stories to tell, having been a despatch-rider for us in the zulu war. my friends met me a mile or two outside greytown with a mule-cart, in which we drove up to their farm--such a delightful old house. it really belongs to mrs. ----'s father, but he is in england now, where they have some children at school; so they have come up from their smaller house in greytown to take care of the farm. i have been here a fortnight now, and have enjoyed every minute of it. for one thing, the climate is delightful. it is pretty hot, but not the damp heat you find near the coast, nor the dusty heat of kimberley. so i am feeling very fit, and the people _are_ so nice i should like to stay for months. it is a very free-and-easy life, and we are waited upon by a man in a shirt and an apron of cats' tails! it is very pretty country, and i am having delightful rides on a good horse. one day we rode out to see some people who live fifteen miles away from here, and they insisted upon our staying the night. of course they don't get many visitors out there. the next morning we rode on to a place where we got a splendid view over what they call the thorne country, right into zululand. we could see the mooi river valley, and they pointed out to me where the "defence of rorke's drift" saved natal. i had never been inside a kaffir hut, so we went one day to explore; and i was taken to call upon "sixpence," a zulu who works here. we had to crawl into the wattle and straw hut on our hands and knees, and at first i could not see anything and could hardly breathe, as the only escape for the smoke from their fire is through the doorway; but we squatted down on the floor--which looked clean and polished with much sitting upon--and soon i made out mrs. sixpence (sixpence can only afford one wife), with a blanket draped around her, and four children. the baby was absolutely naked, and the other children were chiefly clad in beads. and then there was sixpence's mother, a poor old thing who is over a hundred, and can remember chaka, the great zulu chief. i have collected many curios while staying here, and the other day i was given the skin of a huge python feet long, which had been shot near to the house not long before. i can't bear snakes and creeping beasts, and there are a great many of them up here. there is more grass than there is in cape colony, and so better cover for the beasts. the other day, when i was out riding, my horse gave a great jump aside, and after i had remonstrated with him i looked back, and saw a horrid snake sitting up and hissing at us; so i had to explain to my gee how sorry i was that i had spoken! the doctor with whom i am staying has to take very long journeys on horseback to see his patients. he seems very popular, and often has to go to kaffir kraals a long way off, though many of the natives still stick to their faith in the witch-doctors and their weird remedies. very often they have no money, so he is paid in kind; and sometimes he returns from a visit to a chief with one or two cows, which he has to drive home before him. several people have asked me to stay with them; and if i was not in such a hurry to get back to work, i am sure i could put in several months up here with much enjoyment, the natal people are quite delightful, and so hospitable. but john has promised me the box-seat on his noah's ark again on tuesday, and i must once more make tracks for kimberley. xi kimberley, south africa, _june _. i managed my journey back from natal very comfortably, and made several new friends on the way. the drive on the post-cart from greytown to maritzburg was somewhat perilous, as there had been a great deal of horse-sickness about, so that good horses were scarce; and several of our teams were very raw, and there was much bucking and kicking before each start; and several times the harness broke down, and john had to descend to make repairs. i am sure the passengers in the body of the ark were terrified lest the horses should take it into their heads to start off while the reins were entrusted to me; and though i am pretty good at managing a horse, i should be shy of trying to drive six of these bucking creatures. however, we got safely down to maritzburg in the course of the day, and again i had to spend a night there, taking the train the next morning for durban. the railway between these two towns is a wonderful piece of engineering work, crawling up one side of a mountain and scuttling down the other; very fine scenery, with sub-tropical vegetation, all the way down. my good durban friends again met me, and were most kind, putting me up for the night, and then seeing me off on the _courland castle_, rather a tub of a coasting vessel, that gave us such a pitching about that even i succumbed and was sea-sick. this greatly annoyed me, as i had come all the way out to the cape without a qualm! i had meant to do a jaunt up from east london to visit some people at grahamstown and at king william's town, but i was so happy at greytown that i stayed on longer than i intended, and had to give up the other visits. we anchored off east london for some hours, and the captain took me ashore to lunch with some friends of his; and they took us for a nice drive round the town and out to a place called cambridge, where we picked oranges and lots of flowers. the scenery at the mouth of the buffalo river is very pretty. then we went on to port elizabeth, and the captain again took me out to lunch; and we had a pleasant day exploring the town with some of his friends, and in the evening they saw me off by train for kimberley. the train was rather full, but i was so tired that i slept all night, and woke up only just in time to get some breakfast at craddock. i am getting quite experienced in making good use of the twenty minutes they allow you to get meals at these wayside stopping-places. all that day we were strolling along in the train--dinner at de aar junction in the evening--and at a.m. the next morning i reached kimberley. no one to meet me, and no cabs; so i left my baggage with a porter, and walked down to our house. peter, the cat, was holding an "at home" in the garden, and carlo, the retriever, was on the stoep to welcome me, and assisted me to find the key under the doormat; and i was glad to find my bed ready to tumble into, after a much-needed wash. it is winter here now, and the people seem rather more energetic than usual. i have been to two dances since i got back, and there are some dinner parties in prospect. the other day i went down a diamond mine--a thing visitors don't often do, though, of course, a good many see all the workings above ground. i had to dress up in a canvas overall suit and sou'wester, and then, in a very rough cage, we were lowered to the -feet level. i hear they will soon be working at feet below the surface, but feet is the depth they are working just now. it was all very interesting--swarms of natives (with very little on!), and the fussy little trucks rushing about with their loads of the blue-stone, in which the diamonds are found--but i was rather glad to get back to the daylight again. then on sunday afternoon i was invited to go and see a war-dance by the zulus in the mine compound. it was really very fine. only one tribe is allowed to dance at a time, or there would soon be fighting; and the men of the other tribes kept away at the far end of the compound, and would not look on. there were about forty zulus dancing. they were dressed in little aprons of cats' tails and a few beads, and wore feathers on their heads, and were waving skin shields and knobkerries (sticks with weighted knobs). they all stood in a row, and stamped, and clapped, and danced, and sang in very good time; and then single ones stalked out in front of the others, and, throwing themselves into extraordinary attitudes, with much stuttering and stammering, they recounted the great deeds they had done in war, and the others all chimed in with great "hoos" and "hoofs" of approval, stamping on the ground like angry bulls. some of these men fought against us in the zulu war. after the dance was over, one very line fellow was introduced to us as the man who had carried a lot of englishmen out of the mine when it was on fire a year or two ago. i think it is a wonderful system by which all these tribes--that have hated each other for generations--can be made to live together in one compound, working side by side, and earning very good wages. they have separate huts and messes, but they buy at the same store, and share the same chapel, hospital, and swimming-bath. there are about men in the compound, and they all seemed very happy. no beer or spirits are allowed. any man who likes can learn to read and write while he is in the compound; and many of them were sitting round the fires, where they were boiling their mealy meal, reading to their mates. we went into the hospital, which was very clean and trim. natives in white suits, acting as attendants, showed us with pride their neatly-kept charts. there were one or two minor accidents in, and some bad cases of pneumonia, but they all appeared well cared for and comfortable. the lady who lent me her horse has now returned to kimberley, so i have not had so much riding lately; but the other night we had a glorious scamper out to alexanderfontein by moonlight. about ten of us went, and we had supper out there. we had rather a mixed lot of horses and saddlery, and on the way back first one saddle came to grief, and then another. i distributed my gear by degrees--a girth to a gentleman who was riding with only one girth and it gave way, and i had two; a stirrup to a lady who dropped hers, and came off in consequence; and one of my reins to another lady, whose horse was too excited by the crowd of us, and required to be led. the others chaffed me, and begged for the bridle, and then for the saddle! now i am busy packing up for home, and trying to arrange things for my brother, who, when i go, intends to move into a smaller house just opposite to the club. there is also a good deal of tennis on just now, and between whiles i am struggling to pay my farewell calls. i was rather surprised to find there were about forty people i ought to call on; and as kimberley does not wake up from its siesta until p.m., and it is dark by p.m. now, it is difficult to get through things, and george will have to take some p.p.c. cards round for me. r.m.s. "scot," bay of biscay, _july _. i am sorry i neglected to post this yarn from kimberley; but i believe i will still post it when i land, as i may not see you yet awhile, and it will bring the history of my travels up to date. i was more sorry to leave kimberley than i expected to be; but i suppose one can't live in a place for a year without making some friends whom you are sorry to leave. i journeyed down to the cape all alone; but some cape town friends came to see me off, and it was quite home-like to be on the _scot_ once more. the chief officer invited me to sit at his table, and we have had a delightful voyage, good weather, and pleasant people. we had a few hours ashore at madeira, and i think the flowers seem more beautiful every time i go there. some day i should like to stay some weeks in the island. we were all shocked to hear of the wreck of the _victoria_ off tripoli, and the loss of lives; it does seem terrible. we find that, if all goes well, we should land on the day of the wedding of the duke of york and princess may. the bay of biscay is behaving like a lamb. this is the fourth time i have been through it, and only once has it kicked up its heels and been really disagreeable. i am going to spend a few days in town before i go home, so as to be interviewed by two or three matrons of the big hospitals. i think i know which hospital i would like best to get into, but whether i can persuade that particular matron that she really will have a vacancy in the autumn (i must spend a little time at home first), and that i really am the most suitable candidate for that particular vacancy, remains to be proved. i am rather thin in consequence of the heat, but i am as brown as a berry; so i am sure they ought to think i look tough enough for the work. xii general hospital, london, _may _. it is a long time since i last wrote to you, but there has not been much of interest to write about. i tried very hard to get into some london hospital last autumn, but could not find a vacancy in any really good one, so i made up my mind it was better to wait for a vacancy here--where i had always wanted to train--than to slip in anywhere, where i did not _know_ that the training was good. so i have just stayed at home, and in the summer played tennis and cricket, and learnt to make butter and jam, &c., and in the winter had a little hunting (on rather a stupid horse that was always doing something foolish, and one day distinguished himself by lying down at the meet!), and helped to teach in the night-school, where big lads and men, who had been cutting turnips for the sheep all day, came in the evenings to learn arithmetic, geography, &c., with much perseverance. i went to help at the n. general hospital for a month in the autumn, as they had a lot of nurses ill. it was rather funny, as i was sent to a men's ward ( beds) as staff nurse; and of course i had had to do only with children before, so i had to pretend to know rather more than i did. i had been there only a few days when the sister of my ward went off duty with influenza, and there did not seem to be any one to come in her place; so we had to muddle along without a sister. but everything went on all right, and the patients did well. the matron asked me to stay on permanently; but i thought a london certificate would be more valuable afterwards, so i only stayed until their sick nurses were able to return to duty. i rather enjoyed my time there. the rough cleaning work that we had had to do at the children's hospital was all done by ward-maids, so we were able to give all our attention to the actual nursing; also our food was better, and more plentiful. but in spite of these things, there seemed to be a great deal of grumbling amongst the nurses. i was not accustomed to this, and i was not there long enough to learn whether they really had any good cause for their complaints. the work was certainly hard, but that was partly because so many sisters and nurses were off duty ill; and when the doctors found that i was doing the sister's work as well as my own, they were most considerate in trying to save me trouble. i had been promised a vacancy here "in the summer" as an ordinary probationer for three years' training. then, one day early in february, i had a wire from the matron asking me whether i would like to enter as a lady pupil "if my fees were arranged for," and if so, i was to go up to see her the next day. i could not understand a bit what it meant, but thought i had better investigate. so up i trotted to town, and the matron explained to me that they have a system here of working in two ranks, officers and privates. the officers are the sisters, and they are recruited from the lady pupils; the privates are the probationers, who might rise to be staff nurses, but beyond that there is no promotion from the ranks. therefore, if i entered as a probationer, as i had arranged, i could never rise to be a sister. then she told me that it was probable there would be two or three vacancies for sisters in about a year, and a lady who was interested in the hospital had offered to pay the fees for some lady pupil, who would otherwise have entered as a probationer, so that she might have the advantage of the chance of promotion; and the matron had decided to give me the offer, partly on account of my having had previous training. of course there is no _promise_ of promotion, as that must depend on one's work; but there is the chance of it. did you ever hear of such good luck? of course i was only too glad to accept, and they wanted me at once; so i had to get my kit ready in a hurry, and began work here in february. this is a huge place, quite a little town in itself, and i am very happy here. i think i have been lucky in being first sent to a men's medical ward of forty beds. the sister is a first-rate nurse and a splendid manager. she works hard herself, and expects every one else to do the same; so the ward always looks trim, and the patients are very comfortable. my short experience at n. has been very useful to me, and i don't feel so much at sea in doing things for the men. i find that, as lady pupil, i am really acting as "sister's assistant." i go round with sister with the doctors, and if she is engaged with one doctor and another one comes, i have to escort him round; and it is necessary for me to know all about the cases, so as to be able to report about them. another of my duties is to give all the medicines, and that for forty medical cases takes up a good deal of time. i also have charge of four beds, and do everything for the patients in them. there are two staff nurses and two probationers (also two ward-maids), and i fill in my spare time with helping them in bed-making, carrying round meals, &c.; but i don't seem to be expected to do any of the cleaning work, and if i am busy helping sister, the routine work goes on just the same without my assistance. i am not quite sure that it is a good arrangement, as one of the staff nurses in this ward has been here for years and years, and the other one for over three years, so of course they know more about the cases than i do; and i should think a brand new lady pupil, who had had no training before, might find it rather difficult. but i must say the staffs have been very nice to me. i didn't mean to let it be known that i "had been out before," but it leaked out. there are about twenty of us lady pupils, and we live in the matron's house. we have all our meals in the large nurses' dining-hall--but at a separate table--except supper, which we have in the sisters' dining-hall. the food is ever so much better than it was at the children's hospital. some of the nurses grumble at it; but i think wherever people feed in a crowd there are always some who grumble. at any rate, it is not _necessary_ to buy food here. at first i had rather uninteresting cases in my beds, but now sister is giving me some good ones. i have one jolly fat baby of two and a half with tonsilitis, who was sent to us from a women's ward, because they were not sure that he was not going in for diphtheria, and they had other children in the ward. i had to do a good deal of treatment for him at first, and he hated it; but now he has forgiven me, and we are excellent friends, and all the men are doing their best to spoil him. then i have a poor man with bright's disease, who is very ill. he is a curious-looking object, as he is quite bald, and he likes to wear a red knitted cap in bed. he is often delirious now in the evenings, and then he uses very bad language. when sister is out in the evening, i have to read prayers in the ward. at first i was very shy of reading before all these men, especially when some of them are of quite a superior class; and when i was in the middle of prayers the other evening, my bald-headed man chimed in with a lot of bad language. it was really very trying, and i knew if either of the nurses went to remonstrate with him, he would only continue in a louder voice; so i had to shorten the prayers somewhat. if he continues like this, i am afraid he will have to go to the strong-room; but up there they have only male attendants, and we are rather loth to send him off, as he is really very ill, and needs a lot of nursing. a sad thing happened the other day. we had an old man in very ill with angina pectoris; he had great difficulty in breathing, and could not lie down at all. i was always trying to prop him up and make him comfortable. he got very little rest, but he was always so good and grateful. he was not one of my own cases; but he was on several medicines (to be given as required), so i had to go to him very often for one thing and another. one day i was going round giving the two o'clock medicines, and when i got to his bed, he was lying back on his pillows apparently asleep. it was so unusual for him to look at all comfortable, i thought i would certainly not disturb him for his medicine. sister was talking to a doctor a few yards away, and i was just going to point out to her that the old man was resting, when something made me turn back and look at him more closely, and i found he was quite dead. poor old fellow, he was indeed "resting." i just pulled a screen round him, and then called sister and the house surgeon; but he was quite gone, and even the man in the next bed had not noticed any change. xiii general hospital, london, _august _. with much sorrow i left my nice and interesting men's medical ward, and found myself landed in a smaller surgical and accident ward for women and children. there could hardly have been a greater contrast. there everything was done with order and method, and well done; here every one seems to rush about in a breathless way, and the ward never looks tidy, and i am quite sure that the bustle that goes on is bad for the serious cases. i am responsible for eight cases instead of four, and at first i thought i should never get them all washed in time in the morning; but now i find so many of them can do a good deal more for themselves than the medical cases could; also the medicines in a surgical ward are nothing to those in a medical; so i get through all right, and keep up to time. three surgeons have beds in the ward, and that makes the work a little difficult, as sometimes they all arrive at the same time, and sometimes they all want to operate at the same time. this is most awkward, as we have not got fittings for them all, and have to run backwards and forwards for things. they seem to me a most amiable set of surgeons; i know the surgeons at our children's hospital would not have put up with being kept waiting as these men do; but i do hate not having everything they want ready before they ask for it. however, i am beginning to feel my way, and i think i shall soon be able to get different sets of things ready to use in these emergencies. it took me some time to find out why the ward was always in a state of chaos, and it is only because you are so far away that i can safely tell you the reason. i believe it is simply and solely because the sister, though a fairly good nurse, is really no good as a sister. i am sorry to say it, as she has been very nice to me, and the poor thing tries her best. she runs about, and does many things that the junior probationers ought to do, but she has no idea of looking after the nurses; and as the staff nurse is rather a shirker, and is very fond of chattering to the dressers, the probationers who are keen to work are rather overworked, and those who are not keen don't work. also, if there is a rush of work, sister rather loses her head, and runs about in an aimless sort of way; and in the theatre, if anything goes wrong, and they want things in a hurry, she always seems to hand the wrong thing. i find it a bit difficult, as the doctors get in the way of turning to me if they want things quickly. as soon as i found out what was wrong with the ward, and that sister was quite nice and "meant well," but just had not got it in her to be a good manager, i made up my mind that the ward _should_ be a smart ward, in spite of obstacles, and really it is improving by degrees. i have been having a good deal of correspondence lately about a small boy who, sister said, would have to go to the workhouse when he leaves here, and i thought he was a suitable case for dr. barnardo's homes; so she said i could try if i could get him in there, and i have just succeeded in doing so. his mother died when he was born, and his father appears to be a thoroughly bad lot, generally in prison. this boy had lived with his old grandmother and run wild; a pretty little chap, but quite a heathen, and fond of using bad language in the most innocent way. he came in here for a small operation, and while he has been here his grandmother died very suddenly. the people at dr. barnardo's homes have been very good about it, made all inquiries for themselves, and got the father's consent. now they have agreed to take him as soon as he is well. he is a plucky little chap, and i suppose they will probably ship him over to canada one day, and that will give him a better start in life than he might get from a workhouse. i think we get very good times off duty here--one hour off one day, and three hours off the next; and the sisters and lady pupils have a saturday to monday once a month--that means from p.m. on saturday to a.m. on monday. when i was moved to this ward, i just missed my saturday to monday; so, to make up for it, they gave me "extra leave" last week from saturday afternoon to monday night, and it just happened to be may week at cambridge, so i went down and had such a jolly time. b. seems to be very happy at clare, and to have very nice friends there. my sister was up for all the week, and having a first-rate time, going to all the dances, &c. it was my first visit to cambridge, and there was so much to see. it ought to be easy to work when you are in such beautiful surroundings. on the way back the engine of my train broke down, and i did not get in till p.m., and i had to go and confess the next morning in the office that i was late; but it was the first time i had been late since i came, so i was forgiven. we had rather an exciting "take-in" week a fortnight or so ago: first of all a poor, tiny baby with a very badly-cut throat (done by its mother, who had afterwards proceeded to cut her own throat, and killed herself). they did tracheotomy for the baby, but it lived only a few hours. then came a poor little girl of eight, very badly burnt. she had had to get up to light the fire while her mother lay in bed (from her looks, i should think the mother had been drinking), and the child managed to set herself on fire. i think she will pull round, but it will be a long time before she will be able to walk again. she does not have much pain now, and i think she is quite enjoying herself here. the next case was another cut throat--a poor, feeble-looking woman, whose husband had first cut her throat and then his own. he is in the male accident ward, and not very much damaged; she is a good deal damaged, but i think they will both recover. i had arranged to go to the academy with l., as it was my free afternoon; but this poor woman came in soon after dinner, and i knew she would have to go up to the theatre, so i wired to l. that i could not meet her. and it was just as well i did, as three more accidents came in that afternoon, and one of these too had to go to the theatre (a compound fracture of the tibia and fibula); so we had a rushing time. yesterday was theatre day for our ward; and as sister had had to retire to bed with a sick-headache, i had the honour of taking our cases up to the theatre. i was rather nervous, as it was the first time i had been up alone for our senior surgeon, and he had one bad case--an excision of knee. but the other three cases were not very bad ones, and we got along all right. for the last three months we have been having a very interesting course of lectures on physiology, and the girl who shares my room and i spend all our spare minutes in reading up the subject. she is clever, but has not read much physiology before, so i have been able to help her a bit; and i should not be surprised if she does better in the exam. than i do. we are both of us looked upon as quite juniors amongst the lady pupils; but i don't fancy the seniors are taking much trouble, beyond just writing out their notes of the lectures, so i hope we shall do pretty decently. it is not easy to get much time to read when you have a heavy ward to wrestle with; but i am sure it helps you in exams. if you can manage to read rather more than you are absolutely obliged to about what the lecturer is trying to stuff into you in a condensed form. i have been here six months now, and may get sent off for my holiday any day; but there has been some delay on account of sister not being very well. she does not seem to want me to leave, as i shall probably not get sent back to this ward afterwards; but it has been very hot of late, and i shall be glad of a rest. xiv general hospital, london, _december _. after my last letter to you i was bundled off for my holiday. i was glad enough to get it, but i missed the last two physiology lectures. this was rather a bore, as the exam. was the day after i got back; so i had no chance of borrowing any one's notes of those lectures, as i was supposed to do. however, i came out third, and my stable companion was first amongst the lady pupils--not so bad for two juniors; and we heard that four or five of the seniors had a little interview with the matron in her office, and were advised to work rather harder before the next exam. now we are having lectures on dispensing, and they are the most interesting lectures i have struck yet. we go down to the dispensary, and the head-dispenser makes us mess about, and make up prescriptions, and make pills, powders, &c. we fire off questions at each other at odd moments, when we meet--and also in bed at night--as to the various doses of different drugs, and what they are prescribed for, and the antidotes for different poisons, &c. i was sent to a very nice women's medical ward on my return from my holiday, and had some interesting work there. the sister was very nice to me (she has been here for years, and many of the lady pupils don't like her, but she is a first-rate nurse), and she gave me very good cases. one of my first cases was a little girl of ten with typhoid fever. she was very ill for some weeks, and then such a poor little wasted skeleton of a child! it was very nice feeding her up, when once it was safe to do so; and her great big eyes used to follow me about the ward, wondering what the next feed was going to be. sister said that i could hardly have had a more instructive case, as she had nearly all the bad symptoms a typhoid case can have, including a good deal of hæmorrhage. i was horribly proud one day when the senior physician was going round and lecturing to the students and speaking to them of the necessity for good nursing in typhoid; and he made sister show them the child's poor, bony little back and legs, with not a red mark on them; and he told them it had taken all her strength to battle with the fever, and if she had also had a bed-sore to sap her strength away, she could never have pulled through. we had two diphtheria tracheotomies while i was in that ward; and though they were not my cases (as they both had special nurses), i was present at the operations, and i learnt a good deal about their treatment, as sister used to let me relieve their nurses for meals, &c. and she taught me to change and clean their tubes, and so on; so that when i was put on as a special later on, i was not so much afraid of accidents as i should otherwise have been. it must have been a very bad form of diphtheria, as one of the specials became infected, and had to go away to the fever hospital; and then sister took it, but she was not very ill with it, and she was nursed in her own room. it has made them talk about the necessity for some isolation ward to put these cases in. of course they are only taken in here if they are too ill for it to be safe to send them on to the fever hospitals. we had a busy time when sister was ill, but the staff nurse was very good and to be depended upon, and things went on all right. i must tell you of a little joke we had one night in the matron's house, where all the lady pupils live. late one evening in september, when we were all undressed, one of them came to my room and said there was a wretched cat on some leads outside the bathroom window, and it was making such a row, as it could not escape. we went to inspect, and agreed that a rescue was necessary. by this time most of the lady pupils had assembled, and we fetched a ladder from the boxroom. it was too short; but we tied bath towels to it, and lowered it through the window to the leads. then the stupid cat would not come up, and only cried the more; so i was shoved through the window in my dressing-gown, and they held on to me until i got my feet on the ladder, and could climb down to the cat. just then matron's door opened, and they all slipped away to their rooms. i heard something about "too much noise" and "lights out," and then she came into the bathroom and shut down the window. it was lucky the ladder _was_ too short, or she must have seen it. it was pretty dark, and i was sitting down consoling the cat and waiting till the coast was clear, when i heard a smothered laugh, and then for the first time i remembered the gardens at the back, that belonged to some of our visiting doctors. i had looked at their houses and seen all the blinds down, and i had never thought they might be sitting under the trees at that time of night. after that, i very carefully kept my face to the wall; and soon the window was cautiously opened, and with some difficulty the cat and i were hauled in, and very quietly we pulled up the ladder. then i told them i was certain we had been watched, and we located the garden from which the laugh had come; and next morning, sure enough, there were two basket-chairs under the trees, so we knew which doctor it was. but he never gave us away, and i don't know to this day whether he recognised me; but i often fancied there was a twinkle in his eye when we met. then the question arose what to do with the cat, as it appeared to be hungry, and not inclined to be quiet; so eventually the most innocent-looking lady pupil was deputed to go to the home sister, and tell her she had caught this strange cat in the bathroom, and, as it seemed starving, might she go down and feed it, and then turn it out? the home sister was fond of cats, and her sympathies were aroused; so she assisted in providing it with supper and seeing it off the premises. in november i was sent on night duty. the lady pupils are not obliged to do night duty, as they are only here for one year; but matron was short of senior probationers, and asked me if i would like it, and i thought i would. part of the time i have been an "extra," just helping wherever they were busy, and helping in the theatre for any night operations. then i was put on as "special" with a tracheotomy (diphtheria) in a men's medical ward--such a nice boy, called albert, aged eight. and, when he was getting better, another little chap of three came in, so desperately bad that they had to do tracheotomy in the receiving room; and then he was brought over and put in a cot by my boy's bed, and i looked after them both. poor albert was rather jealous at first, and whenever i was attending to the small boy he began to "wheeze" too, thinking i should rush to his rescue; but he soon found that that did not pay. after these boys had both recovered, i disinfected, and had a night off to air myself; and then matron let me do the staff nurse's nights off--very interesting, but rather anxious, work. you go to a ward which perhaps you have never been inside before, and you don't know where anything is kept. there are from twenty to forty patients; if the latter, there is a probationer to help you. most of them are sleeping quietly; the few who are awake are probably wondering what sort of a rise they can take out of the strange nurse. some of the sisters are very good about giving one a full written report; but other sisters are rather casual, telling you much of what you may or may not do for number eight or number eleven, but seeming impatient if you try to jot down notes. the first night off i took was in a men's surgical ward, where there was a nice lad of eighteen who had had his leg amputated that day (for a tubercular knee). he was so good and patient, but of course he needed a good deal of attention, and i wished i could stay with him all the time; but there was an old man at the other end of the ward rather delirious, and he would insist upon saying his prayers with a loud voice, and confessing his sins to me, calling me "maria, dear." i was thankful when the house surgeon came round and ordered him a sleeping-draught; but it took me quite half an hour to persuade him to drink it, and then it was a long time before it had any effect. in another ward the sister told me that the patients needed nothing to be done for them until i gave them their breakfast in the morning, but "_would_ i take great care of her persian and manx cats, and not let them escape from the ward?" it was also airing night, so i had plenty to do airing sheets, &c., and putting on clean sheets in the morning; but it was not exciting. to-night i am staff nurse in the men's accident ward; but there is a bright little pro. on as well, and she seems to be accustomed to do most of the work. we have had one case in--a van-boy with slight concussion of the brain; but i have got him washed, and he is now asleep with an ice-bag on his head. there are several bad cases in the ward, but they all seem inclined to sleep; so i am actually sitting down to finish up this scribble to you. i like night duty; you seem to have more time to fad over the patients who are really bad, and to do little things for their comfort; and the convalescent ones generally sleep and don't worry you; but it is hard work sometimes, especially between and a.m., when every one wakes up, and every one wants something, and there are all the breakfasts to give round, and all the beds to make, and the temperatures to take, and the fomentations to change, and a hundred different things all needing to be done at once; and you rush around and expect every minute the day nurses will come in and say "what a muddle the ward is in!" and sometimes, when you are beautifully forward with your work and think sister will be pleased, a house surgeon runs up in his pyjamas and dressing-gown to say he is sending in a bad case, and then you have to give all your attention to that case, and can't do the final clearing up for which you thought there would be heaps of time! xv general hospital, london, _june _. many and various are the jobs i have done since my last letter, and now i must tell you that i am a full-blown sister or, as they say here, i have got "my blue"; but i had better begin where i left off. i was then bustling about on night duty, and i spent a very happy christmas like that. of course, we should all like to be at home for christmas, but in hospital so much is done to make it bright and cheery for the patients, and so many of them have so little brightness in their lives, that it is nice to see how thoroughly they enjoy it. they all have really nice presents; there is any amount of good food provided; plenty of entertainments (music, christmas trees, &c.); and the men are allowed to smoke in the wards. the doctors and students are really splendid in the way they work at decorating the wards, &c., and carrying the patients who are well enough about to other wards for entertainments. the children of the slums around here will do anything to get into the hospital for christmas, and the front surgery is full of little imps who have all got a "very bad pain!" in january i had to retire to bed for a few days with a high temperature and a touch of influenza, and while i was in bed the day came for the dispensing exam., so i begged to be allowed to go, and vowed i was quite recovered, and they let me attend. i made up my prescriptions (a bottle of medicine and some powders), and then i got under way with the paper, and thought it was rather a nice one, but before i reached the end my head began to swim, and i felt convinced i had mixed everything up and given all the wrong doses, and i thought what an ass i had been to try it, and i was certain i should come out at the bottom of the list! one of my friends escorted me back to bed and took my temperature, and when she found it was she went off and told the matron; so next morning the doctor appeared, and i was kept in bed for a whole week, and then sent away for a few days' change, but before i went away matron came to tell me that i was first in the dispensing exam., with marks out of a possible . if i had any more exams. to go in for, i think i ought to arrange to have a little influenza beforehand, as it seems to stimulate my brain; but, thank goodness, that is my last. you know i have always vowed that nothing would induce me to be a matron? well, i have been rather near it; i have been acting as assistant matron for some time. first of all, the assistant matron was ill, and went away for a bit, and i did her work; then, when she came back, matron went away for a fortnight, and i stayed on in the office helping the assistant. it was rather interesting learning the ins and outs of the "administrative department," but i am still convinced that it is no catch to be a matron. sisters come to complain of a nurse, and you have to send for that nurse and scold her for her reported misdeeds, when, perhaps, all the time you have rather a feeling that sister has been unreasonable in what she has expected of the girl. then nurses have a way of sometimes getting ill, and it always seems to be the nurse whose place it is most difficult to fill; then matron goes out for the afternoon, saying to the assistant, "there are three extra nurses, and i have sent them to wards a., b., and c., where they are busy, so no one is likely to ask you for another extra," and as soon as she has gone a house surgeon runs in to say he has sent in a very bad diphtheria case to ward d. for immediate tracheotomy, and can i send specials over at once? i look on the list to see who the three extras are, and find not one of them is suitable to take on the case--one is going for her holiday in a few days and the other two are quite juniors--so i rack my brain to think which of the ward nurses is most suitable, and fix upon pro. in ward a., as she has nursed one or two tracheotomies; so i have to interview sister a., and she is most reluctant to give up her pro. , and is quite certain matron would not have taken her away, but i have to be firm and try to console her by sending her the best extra in place of pro. (thereby incurring black looks from sister b., who is quite sure her ward is far heavier than sister a.'s!); some one ought to be sent to bed to be ready to act as night special, but i conclude that can wait till matron returns, as she may have some nurse she has promised to put on as special. that is the sort of work the assistant matron has to do--a good deal of fagging about and acting as a sort of buffer between the sisters and the matron, much writing of letters and other work in the office, and a good deal of carving at meal times--one sunday i carved roast beef for seventy nurses, some of them day nurses and some of them night. i had just come to the end of my time in the office (i was still a lady pupil then), when an appeal came to the matron to lend two staff nurses to one of the large london infirmaries, where they had a great many nurses ill. i volunteered to go (as i thought it would be a new experience), and then another lady pupil also volunteered. it was a pouring wet evening in march when we set off in a hansom cab, the other lady pupils rather jeering at us, and saying that when _they_ went to the workhouse they should do the thing correctly in an aged four-wheeler! we had no idea where the infirmary was, but trusted to the cabby, and after a long drive he turned into a stone-paved yard and drew up at a heavily-barred door; it looked more like a prison than an infirmary, but i got out in the rain to explore, and after a little while i managed to explain to the old man in charge that i did not wish to apply for admission to the casual ward, but to find the infirmary. he told me that was more than a mile farther on; so the weary horse plodded on once more, and eventually brought us to an imposing building, where, in three weeks of hard work, we learnt many things. they were very busy and very short-handed. i was sent to a women's medical ward of thirty-two beds, but the place was so full that i had thirty-six patients, the extra ones sleeping on mattresses on the floor. for the first week, whenever a patient came in, i had to consider which of those in beds was the most capable of turning out and descending to the floor, to make room for the new-comer, but after that things quieted down, and before i left the patients were reduced to the correct number. there was a sister in charge of my ward and of another one just opposite of the same size. for a few days i worked with the staff nurse, and then she had to leave, and i was left to do the work of the ward with the help of a probationer, who came in for an hour and a half every morning, and who relieved me when i went off duty every other day; and on the alternate days, when the staff nurse from the opposite ward was off duty, i had to patrol her ward at intervals, and give the probationer any help she needed. at first i was appalled at the small number of the nursing staff for so many beds, but i soon found that everything was done in a way very different from our hospital methods, and that if we worked hard and fast it was possible to do all that was really necessary for the patients, but quite impossible to do the little faddy things that make so much difference to their comfort. for one thing, the convalescent patients were expected to do a great deal of the routine ward work, and, as a rule, the convalescents stayed in much longer than they do in a hospital, so they were more fit to assist, but this hardly applied to my short time in the infirmary, owing to the great pressure on the beds; also i found that there were only about six or eight out of the thirty-six patients really acutely ill, so i was able to give most of my attention to them--three of them were absolutely helpless, and needed much care and nursing. the rest of them were chiefly old ladies who were just not strong enough for the workhouse life, and so were drafted into the infirmary; most of them were able to get out of bed and potter about the ward. this they loved to do with very scanty clothing on--rather to my horror--and i found that when a doctor was sighted on his way to the ward it was best to clap my hands vigorously, when all the old dames scuttled into bed like so many rabbits into their holes. poor old things, several of them had evidently seen better days, and there were many sad stories to be listened to, and they did so much appreciate the little i could do for their comfort. it was very hard work, as one always seemed to be working against time, but i quite enjoyed my three weeks in the infirmary. matron had not told us we were to be paid for this work, so when we each received £ . s. for the three weeks, we felt very rich! we were quite glad to return to our good old hospital, and since then i have been doing sister's holiday work, and now i have just been appointed sister in the front surgery (where all the new cases and accidents come in); it is utterly different from being in the wards, but i think i shall find it interesting--at any rate for a time. i shall wait to tell you about it until i have been here a little longer, and have taken my bearings more correctly. xvi general hospital, london, _january _. i think i shall be rather glad when i get a ward of my own and settle down; but every one seems to think i am lucky in getting such varied experience, so i suppose i ought to be grateful, and it is not yet two years since i first entered here. i spent six months as sister in the front surgery, and it was very interesting. there had never been a sister in charge there before, but just one old staff nurse, who had let the dressers do just what they liked, and there was a lot of waste and much disorder. matron gave me a very good probationer, and she was just as keen on getting the place nice and trim as i was. it took us a week or two to get all the drawers &c., scrubbed out and tidy, and a good many more weeks before we got all the splints sorted and padded. the medical superintendent was pleased, because i managed to reduce the cost of dressings every week from £ to £ before i had been there a month, and it was still further reduced after a few more weeks. of course it is difficult for young dressers (who come on for only three months at a time) to understand how much difference a little extravagance in each dressing makes in the weekly bills; and they can't be expected to know the relative value of different kinds of wool, &c., unless it is pointed out to them, but as a rule, when they do understand, they are quite willing to use the cheaper dressings (for cases where they do just as well) provided that we keep a supply ready to their hands. i often wonder whether, when people go round a hospital and see the rows of white beds and clean patients, and everything neat and tidy, they think the patients arrive here looking like that. very often in the wards, when the porters have carried up an accident case on the stretcher, i have hardly known how to get the man's dirty clothes off, and it takes time before you can get them reasonably clean; but in the wards you always receive a note or a message by the porter from the house surgeon, with a rough diagnosis of what the case is, so that you know which limb to be especially careful in moving. but it is different when you receive a patient in the front surgery; the policemen tramp in and deposit the stretcher on the floor, and there is much mopping of their foreheads before they tell you roughly what they know of the accident, and then you have to proceed to find out for yourself what is the extent of the injury, and often the patient is quite unconscious, so he cannot help you at all. i think at first i had a dim notion that every case that was carried in on a stretcher was sure to be admitted to the wards, but one soon learns that a good many of these cases are more frightened than hurt, and after a little rest and a thorough overhaul by the house surgeon they are able to go home again; on the other hand, every now and then a man who has had a very serious accident will manage to walk up to the hospital, and he may even sit down amongst the other waiting patients and quietly wait his turn to be seen, unless you happen to be on the look-out, and note that he is looking ill, and get him on to a couch for immediate attention. there is generally plenty doing in the front surgery, and whenever any of the men have nothing better to do they stroll in to see what is going on, so one hears all the gossip of the place; very quaint, too, are the tales the patients tell of their symptoms. i am not good at remembering these things, but there was one old lady who said the doctor told her that she had "the brownkitis, and that all her tubs (tubes) were full up." sometimes we had exciting times. i remember one morning when i came on duty the night nurse reported that a bad case of compound fracture of the jaw and other injuries had come in, and been taken straight up to the theatre, and that the house surgeon and all the available dressers were busy with it then. she had no sooner gone away than in tramped four big policemen with a stretcher, which they deposited on the floor; on uncovering the patient i found a poor man on whose head several heavy planks had fallen. part of the scalp was torn up, and it was bleeding profusely. i sent my probationer flying to the theatre to ask for some one to come to help, and then i made one policeman put pressure with his finger on an artery on one side of the head and another policeman on the other, while i collected some dressings, forceps, &c. much to my astonishment, first one policeman fainted and subsided on the floor, and then the other one did the same (the other two had gone outside); then the probationer returned to say the man in the theatre was bad, and they could not spare any one, but some one would come as soon as possible. just then the police inspector walked in, and his look of astonishment at his two prostrate men was very fine, but he called the other two men to move them, and then he gave me the help i needed, while the probationer and i did what we could to stop the hæmorrhage; it was pretty well subdued by the time the house surgeon got down, but he saw at once it was a bad case, and took the man straight up to the theatre. as soon as he had gone we dosed the two policemen with mist. ammonia, but it was a little while before they were fit to return to duty, and then we were just thinking we would begin our much delayed morning's work when, strangely enough, two men were carried in dead, the two stretchers arriving within a few minutes of each other; one was a suicide from the thames, and the dressers tried artificial respiration for some time, but the poor chap was quite dead; the other was a poor old gentleman who had apparently died of heart failure when hurrying to catch a train. we saw a great many infectious diseases in the front surgery, and had to keep them in an isolation room till the fever ambulance came to fetch them. i remember one day when we had samples of nearly all the infectious fevers to despatch--first came a case of smallpox, then one of scarlet fever, then one of diphtheria, and there were also cases of measles and chickenpox, but these had to be sent back to their homes. there was quite an outbreak of smallpox just then (i think we had twenty cases in the front surgery in one week), so everybody in the hospital who had not been recently vaccinated had to be done, and we were all very sorry for ourselves for a time. another little episode in the front surgery was when a baby took us all by surprise by being born there! we should have sent it on to the infirmary, but the mother was rather bad, so we had to take them in. one sunday evening i was in chapel when i heard some one come to the door, and then the porter came to fetch me, and at the door i found one of the dressers who told me there was a bad compound fracture in the surgery, and the house surgeon would be glad if i would come, as he wanted to give an anæsthetic. when i got there i found a crowd of men all standing round a poor little dog with a badly crushed leg! so we got some suitable splints, and they gave it an anæsthetic and put up the fracture; then they sent word to the male accident ward to get a fracture bed ready for a patient, and the porters were secured to carry it along on a big stretcher. it was in the hospital for some weeks, and got quite well again. just before christmas the matron was obliged to go home for a time, so once more i was asked to go on duty as assistant matron. christmas is always a busy time all over the hospital, and in the office (with the matron away) we had more than enough to do--so many presents to receive and acknowledge and distribute, and many visitors to show round, &c. then, after christmas, a good many nurses got ill (some with influenza), and every one seemed to be wanting special nurses at the same time, and all were quite hurt that i could not make new nurses to order. so i was not sorry when the sister of the nicest ward in the hospital told me that she had been appointed matron of another hospital (she had been here for years), and as she knew nothing of office work she wanted to ask matron if she would have her in the office for a few weeks' experience. i thought it would mean that i should go back to the front surgery, and i was quite pleased, but instead of that, matron wrote to ask me to take over that sister's ward for a couple of months, as she had not got a suitable sister ready to take it permanently (it is always given to one of the seniors here); so i was still more pleased, especially when i found that the pay was at the rate of £ a year more than for the other wards. this is an awfully nice ward of thirty-two beds, in two divisions--one for men, and one for women and children. it is chiefly for medical cases, but there is a small theatre attached, and a good many abdominal operations are done; there is also a private ward, to which the surgeons can send any operation cases that need especial attention; and they have special nurses. in the wards i have a good staff, as it is always considered the most acute ward in the hospital, and i can generally get an extra nurse if i want, so i don't do much actual nursing myself, but there seem to be doctors constantly going round whom i have to attend, and somehow i always seem to be busy. the longer i am in hospital the more i see how much harder it is to be responsible for other people's work than just for your own, and i can quite understand why so many of the staff nurses much prefer to do all the best part of the nursing themselves than to teach the probationers and let them do it; but it is a wrong principle, as the probationers must be taught, and we must learn to trust others (even when we know we could do things quicker and better ourselves), and to increase the trust just in proportion as we find them worthy of it; that is where the art of the teacher comes in! xvii general hospital, london, _december _. i think i last wrote when i had just taken charge of c. ward for two months. i had a most interesting time there, and was quite sorry to give it up, but it was hard work. unlike the other wards, that "take in" new cases for a week and then have a rest, c. is always "taking in," as the men in charge see every new case that comes up to the hospital (except accidents), and they can take them in if they like, as long as there are any beds empty in the ward; and if they don't think it is a particularly interesting case, it is passed on to the house surgeons or house physicians for the other wards; but, of course, they try their best to get all the most interesting cases for themselves; consequently the sister is never free to go out with any confidence that no new cases can be landed in while she is away; and when you do go out you generally find on your return that something has happened that makes you wish you had never gone! still i learnt a great deal in my time in that ward, and i enjoyed it. the physicians' talks with the students over these "selected cases" were most instructive. soon after i took charge we had a run of tracheotomies; the first was a dear, fat baby of thirteen months, but it had diphtheria very badly, and was not a hopeful case from the first; not many hours after it was operated upon another came in--a sweet little boy of three called "alex." he was much relieved by the operation, and got on so well; but the poor baby ran a temperature of ° all through the second day, and died late that evening with a temperature of °, in spite of all we could do for it. i believe we were much more cut up about losing it than the mother was; she did not seem to mind a bit, and apparently had made all her plans for the funeral beforehand--and it was such a pretty baby too! the special nurses i had for these tracheotomies had never nursed one before, so you can imagine i could not leave them alone much, and was thankful i had had a good many to nurse when i was a lady pupil. we had one very curious case. a young man was brought in unconscious one afternoon about p.m.; a little after five he got worse, and his respiration suddenly stopped, the pulse went on steadily, so they did artificial respiration; this went on till . p.m., and then they decided to trephine, thinking it must be a cerebral tumour pressing on the brain; of course no anæsthetic was necessary, as the poor man showed no sign of life except that the pulse was beating; they could not find any tumour, so he was put back to bed, and the men went on doing artificial respiration all through the night in turns, until the pulse suddenly stopped at . a.m., sixteen hours after the respiration had ceased--a very strange case. we often had rushing days, when it seemed impossible to make time for meals, and scarcely time to breathe. i remember one day especially, when we took in seven new cases, two of them, curiously enough, men from quite different districts, who had both taken oxalic acid with a view to suicide; one was an old man who was very bad for a day or two, and then seemed to be getting better, but died suddenly one night from heart failure; and the other was a poor young fellow of thirty, who had been waiter in one shop for eight years, and was then turned off by a new manager and replaced by a german lad. he had a wretched wife who drank, and she took away his clothes and then disappeared; so we had to rig him up in a suit when he went off; one of the other patients gave me five shillings for him, and he asked me to keep it till he had been before the magistrates, as he thought he would be sent to prison, but he came back after his appearance in the police courts to tell me he had been let off with a caution, and he thought his old master would take him back; such a nice, quiet-mannered man, and most anxious to do anything to help the nurses in their work, or to wait on the other patients, and they all liked him. the same day one of the house surgeons was admitted with a badly poisoned arm, and a friend of one of the students with typhoid fever; he had it very badly and caused us much anxiety, but pulled through all right in the end. after this spell in c. ward i expected to return to my front surgery, but instead i was offered in march (and gladly accepted) the post of night sister, and that is what i have been doing ever since, except for an interval for my summer holiday, and also for a few weeks when i took charge of a large male medical ward while the sister had her holiday. being night sister here means plenty of running about, and plenty of responsibility, but it also means better pay than ward sister, so that suited me all right. they are talking of having two night sisters soon--one medical and one surgical--and there would be plenty of work for two, as we have a good deal of theatre work in the night, and sometimes i cannot help being worried when i am kept long in the theatre with urgent cases, and i know there are bad cases over in the medical buildings (sometimes with only rather junior nurses in charge of them), and i can't get round to visit them. i have charge of about six hundred beds, and they are divided into twenty-one wards (of course nurses in each ward and two nurses in the large wards); i have to go all round three times every night, and run in much oftener to see any bad cases, and the nurses send for me in any difficulty; there is a slate in my office for messages, and when i return after my rounds i often find two or three messages, "please come at once to p."; "please come to n.--urgent," and so on, and i have to fly to whichever i think is likely to be the most urgent. the morning round always takes the longest, as all the patients are then awake, and i have to say good morning to them all, and remember to ask after their particular aches and pains, and it is not very easy to remember what is the matter with them all, though i know very well all the details about those who are very ill and have much done for them in the night. there is one place i don't enjoy visiting, and that is the strong room at the top of the surgical buildings. lately we seem to have had so many men who go off their heads (generally from drink), and if they are left in the wards they disturb the other patients so much that it is better for them to be moved, and then they have male attendants up there; but these male attendants are not members of our regular staff (i wish they were), and i never feel that i quite know their capabilities, or how much i can trust them, and more than once i have found them asleep; so i have to go up very often when any patient is bad there. i remember one night we had a very lively time of rushing about. we began with a man who had cut his throat--not very bad, but he had to go up to the theatre; then a lady who had taken three ounces of laudanum, and the doctors had to keep her walking up and down the corridor, with a weary porter on each side of her, for six hours before they thought it safe to let her turn into a bed; then i was called to a poor man in ward p., who got worse, and died rather suddenly--a phthisis case; next a tracheotomy came in, and had to be done at once, and while we were all busy with it a baby was born in ward d.; but the day sister had to be called to attend to that, as i was mixed up with the diphtheria case, and could not go near a confinement; then a fractured femur came in, and next an acute pneumonia--rather delirious. in the intervals of receiving these new cases and sorting them to the different wards we had to brew strong coffee and administer it to the lady who had taken poison, and provide refreshments for the porters who were minding her. in the early morning she was allowed to go to bed and to sleep; she recovered very soon, and i don't think she will do it again! i joined the royal national pension fund for nurses a few months ago; it seems to be a good thing, and if i can only keep up the premiums i shall have the noble pension of about £ or so when i am fifty; it will keep me in extras when i retire to the workhouse, as i am certain no one can go on nursing for a great many years at the pace we have to go in hospital. just now i am having a rest (and another sister is rushing about on night duty), as i have been warded for the past fortnight, and in a few days i hope to go home for a change. i had a cold for many weeks, and did not pay much attention to it, as i thought it was only because i was about all night and did not get enough sunshine to help me to throw it off; but then i got very bad headaches, so i had to see a doctor, and he passed me on to our nose specialist, who has been most awfully kind, coming down every day, and sometimes twice a day, to see me. it was not really a cold, but some disease in the antrum, and he has done two small operations for me, and it has been horridly painful, but now it is getting well rapidly, and every one has been most awfully good to me, and i am beginning to feel less of a limp rag than i have done for some time past. it was funny spending christmas as a patient instead of running about looking after the patients; but it was nearly my first day up, so i was glad enough to be lazy, and i have had many visitors, so it has not been dull at all. xviii general hospital, london, _september _. just now i am feeling so sorrowful at the prospect of leaving this hospital (my home for the last three and a half years) that i hardly know how to give my attention to telling you how the last few months have been spent. no, i have not been turned out, and they have given me a first-class certificate, and are good enough to say that they are very sorry i am going, and perhaps they will have me back again some day! i think i was warded when i wrote to you last, and after that they sent me home for a little rest. whenever i go home some one in the village gets ill, or some child gets scalded, or some accident happens; they seem to think it is necessary to keep my hand in; but during that visit home my only patient was poor jessie, the family cat! it was sunday evening, and we were all sitting in the dining-room just after prayers, when poor jessie hobbled in, really screaming with pain. one leg had evidently been caught in a trap, and there was a bad compound fracture which she could not bear me to handle, so i said we must either have some chloroform or the poor dear must be shot. the nearest doctor (and chloroform) was three miles away, but c. volunteered to fetch some, and went off on his bicycle, while i prepared some splints and strapping, &c., and poor jessie used bad language under the table. i have sometimes had to hold an obstreperous child while it has been given chloroform, but that is nothing to holding a cat! however, at last we got her under, and then put the fracture in good position and stitched up the wound, securing the leg very firmly on splints; this operation was watched with much interest by all the family and most of the servants; at first the cat would not come to, but we put her in a hamper with plenty of fresh air, and when she _did_ come to, the language she used was "something awful," but she soon settled down and made a good recovery. my people were very anxious for me to say i could not go back to the hospital at the end of my fortnight's sick leave as the cat was still in splints, but i had to leave her to my assistant. then i returned to duty as night sister again, and everything went on much as usual--generally rather more work than i could do well, and sometimes rushing nights of accidents and emergencies, when it seemed almost impossible to fit in all that had to be done. it seems that every year more operations are done; the cases are sent out more quickly, and so make room for more acute cases, and so the work grows, but the number of nurses does not grow in the same proportion. in february there was an urgent call for nurses to volunteer for plague duty in india, so i sent in my name--thought it would be a useful experience--and i wasted much time hanging about the india office for interviews, &c., but eventually they were unkind enough to say i was not strong enough, and refused to send me. _who_ would look very strong after acting for a year as single-handed night sister for a hospital of six hundred beds? then the authorities made a change, and they decided to increase the night staff by the addition of eight more nurses and one more sister. i was only on for a short time after this came into force, just to set things going, and then i was appointed day sister of m. ward, the women's surgical ward, where i had worked as a lady pupil, and knew and liked the surgeons so much. since i was lady pupil there, and before i was appointed sister of the ward, they had had several changes of sisters, and no one who had been there long enough to take much interest in it; so there was room for improvement, and the surgeons have been so awfully kind to me that i have had a very nice time. in that ward my bedroom opened out of my sitting-room (attached to my ward), and we had one very exciting night there. since the night staff were increased the nurses have had one meal during the night down in the dining-hall, and there are some probationers who relieve our staff nurses while they go down to this meal. i was fast asleep one night when a probationer rushed into my room, "oh, sister, come quick, it's all blazing!" i seized my dressing-gown, and was in the ward in a few seconds thinking that she had set the place on fire with the airing sheets (of course my proper nurse was down at her meal); but it was a house just across a narrow road that was indeed all blazing, and my ward was brilliantly lit up by the flames, and the poor patients were all awake, and some of them quite terrified. i turned on all the lights, so that they should not see the glare, and then we did our best to reassure them that there was no danger. two poor women with fractured femurs and their legs slung up to hodgin splints had already hopped out of their beds, and were literally tied by the leg, and they were all begging for their clothes; so i let two convalescents go to the clothes cupboard and put round the clothes to each bed, or dressing-gowns for the helpless ones, while we got our fire-hose out in case of need; but the firemen very soon got the fire under. two of our students, who lived in the house which was on fire, had to jump for their lives, and lost all their belongings, and one of them broke his leg. it was really a bit alarming, as the ward got so hot and smoky, but the patients soon settled down again, and after we had readjusted splints, &c., no one was any the worse. i had to take my month's holiday in june this year, rather earlier than i like (as it always seems more difficult to work when you come back to face all the hot weather), but we can't all have our holidays in the best months. a young brother and a sister and i agreed to spend a fortnight about our old haunts in switzerland, and we had such a jolly time together. of course we went first to paris, and were fascinated with the shops, but tore ourselves away from them to visit the venerable notre dame, and then to spend a little time in the louvre, but it was only time enough just to make us determined to stay longer in paris on our way back. in the afternoon we took one of the boats up the seine, and afterwards went for a walk in the bois de boulogne--a delightful breathing-place for the parisiennes--good roads, lovely trees, and greenery, and yet quite near to all the bustle of the town. the next day we had a hot and dusty journey on to geneva, rather afflicted by the presence of some old ladies who wished to keep all the windows shut--it is strange how these petty discomforts fix themselves in one's mind! at geneva we had vast, big rooms just looking over the lake, in the hotel des bergues, and we took a sabbath-day's rest there, finding a nice service in the english church, and for the rest of the day wandering about near the lake and up the river. the next day we felt more energetic, and b. went off for a trip round the lake by steamer, while we went up salève by steam and electric tram, a lazy way of proceeding, but it was rather an exciting journey crawling up the face of the mountain, and then such a view from the top; mountains, mountains everywhere, and grand old mont blanc poking his head over the top, and down below the lake so still and blue, with green trees down to its edge, and then the trees growing darker as they grow higher up, until they stop and the snow-line begins. the next day we moved on to chamonix; the train went only as far as cluses, and from there we had a drive of twenty-five miles by diligence. it was a delightful drive on a bright, sunny day; at every turn we seemed to get fresh views of mont blanc, and each view seemed more beautiful than the last. we walked a good part of the way while the horses climbed the hills, and we found many varieties of wild flowers and plenty of wild strawberries. chamonix is a charming place, but one wanted more time just to loaf about and enjoy the views. the mer de glace is, perhaps, the most noted glacier in switzerland; it is within easy distance of chamonix (about two hours' walk), and it is a wonderful sight, but somehow i can't describe it, it is all too solemn and grand. i always feel the truth of what the psalmist says about the men that go down to the sea in ships: "these men see the works of the lord and his wonders in the deep," and i think the same applies to those who climb into the heights of the mountains, but i suppose he had not had that opportunity! we left chamonix with regret, and walked from there over the col de balme to martigny; i think it was about twenty miles, but you can walk twice as far in switzerland as you can in england without being tired, the air is so clear and bracing. it was a lovely tramp, beautiful flowers and ferns, and rushing streams and waterfalls; the last part of the way was trying, as it was very steep going down into martigny, and the path was paved with little cobbles, so that we arrived rather footsore. from there we trained to glion, a very favourite place with us, just perched above chillon, with lovely views of lake leman, of chillon castle, and the fine old dent de midi at the end of the lake, and it is within easy walking distance of montreux. there are many nice walks and climbs about glion, and the flowers--gentians, narcissi, &c.--were perfectly lovely. then we had to turn homewards, and found that we could spare only one night again in paris (we had meant to stay longer): still it gave us a little more time to examine the treasures of the louvre. we had a small excitement in the afternoon. we had been walking through the flower market when a shower of rain came on. we sheltered under one of the stalls, and while we were there we heard what we thought was a sharp clap of thunder, but it proved to be a bomb exploding in the place de la concorde, but no one was seriously hurt. when we got back to london it was very busy with preparations for the queen's diamond jubilee, which was duly celebrated with much rejoicing all over the country before i returned to work in town. now, i had better explain why i am leaving here. i have promised to go as nurse to one of the hotels up the nile (either to luxor or assouan, where they always have a doctor and one nurse through the winter season), with a patient who has spent the last eight winters in egypt. he is now very ill, and still he wants to go, as he can live so much more comfortably in that climate. his mother can't go with him at present, and they can't bear to let him go alone, so i have promised to go to see him through the voyage (we are going by long sea) and to be at hand in case he should get worse before his mother can join him. you know i love travelling, so in a way i am glad, but i don't think i am fitted for private nursing, and i am a bit nervous, and also it will be anxious work if my patient gets worse out there, but somehow i could not refuse. it is just horrid saying good-bye to every one and everything here. i will write again soon from the sunny south. xix helouan, egypt, _november _. here we are in lovely sunshine (the thermometer at ° in the shade), just on the edge of the desert, and quite contented to rest a while (after a very anxious voyage) before we move on up the nile. we sailed from london on october st, and had a smooth trip down the channel, but i soon found my patient was much more of an invalid than i had expected, and was afraid he would get cold before we got into a warmer climate. the first sunday out we ran into a dense fog off cape finisterre, and our morning service was somewhat disturbed by the constant hooting of the foghorn; some of the passengers jumped up from their knees at each hoot, and the captain cut the service rather short and went up on the bridge. in a couple of hours we emerged into lovely sunshine, which soon dried the wet decks and awnings, but the next day, as we were putting on full steam to get into gibraltar before sunset, we again ran into a thick bank of fog, and eventually had to change our course and put out to sea until the morning, as they are not allowed to run through the straits after sunset. the next morning i was up on deck before five, just as we were running into gibraltar, and to watch the sun rise from behind the great rock was a most impressive sight. we had a pleasant trip down the mediterranean until we entered the gulf of lyons, and then the wind got up, and there was a nasty cross sea which made most of us feel squeamish and not sorry when we anchored at marseilles early one morning; but there we had to tranship to a smaller steamer, and it was raining and cold, and when we got on board the _clyde_ we found they were still coaling, and that the lighter with all our baggage on board was not likely to come for some time, so we could not establish ourselves in our cabins. as there seemed no comfortable place on the boat, we concluded the best thing to do was to take a cab and drive up to a hotel to get warm. then i went out to buy fresh cream and grapes, and to find out exactly at what time it was necessary to be on board. i shall never forget the storm of that night after we left marseilles. i tried to make some hot arrowroot; with much patience i managed it over a spirit lamp, which i wedged into my washing basin with supports; of course the tin of milk could not be trusted to sit on the top of the lamp, so i had to hold it there, and it was not an easy matter as i was flung from side to side in my cabin; then i found that a linseed poultice was indicated, so i again retired to my cabin and wrestled with the spirit lamp, and thought how little one appreciates the conveniences of a modern hospital until one has to do without them. after that the groans and fearsome noises from other cabins around us were very bad, and i, who have always prided myself on being a good sailor, actually succumbed for an hour or two; but i dragged myself up again in the early hours of the morning to make another poultice, and by breakfast-time the sea began to go down, and the sun came out, but it was several days before some of the passengers crawled up on deck, looking like limp rags, and the tables in the saloon were very empty until just before we reached alexandria. we stayed some hours at malta, and i had an interesting drive round the place. from alexandria we had meant to go straight on to cairo, but eventually agreed it was best to stay a night at a hotel in alexandria to rest before the dusty train journey. we had a wretched night, and, not knowing how to find a good doctor if i needed one, i felt very lonely in a vast hotel where no one seemed to speak english. the next day we managed to journey on to cairo in the morning, and rested at shepherd's hotel until the evening, and then moved on to this place--about half an hour by rail from cairo, and actually on the borders of the desert. we have many friends in cairo, and there is a good train service, so they often come out to spend the day with us, or for the afternoon, and then sometimes i go into cairo to do necessary shopping or to pay some visits. cairo is a very gay place, and the people very pleasant and friendly. one day i went to lunch with some friends, and they drove me to see the citadel (driving all through the native quarter of the town), and then we had tea with the sisters at the military hospital--a rambling big place, designed for a palace and not for a hospital--and they seemed very full up with enteric patients. then we went to see the mosque, and were seized by the feet by several arabs, who tied on sandals for us before we went inside, and in these we were allowed to flop about. the mosque is a vast dome, nearly all marble and alabaster, with a lovely alabaster fountain, where the people wash their feet before going in to pray. we walked all round the fortifications, and had a splendid view of cairo, and then drove back to town just in time to see the khedive arrive from alexandria; a stout, sad-looking young man, his native escort very smart, and riding such beautiful little horses. another day i was invited to bicycle out from cairo to mena house; so i went into cairo by the early morning train, and mounted a hired bicycle for the nine-mile ride to mena house hotel. the first two miles seemed very perilous, as our route lay all through the town, and many water-carts made the roads very slippery, and electric trams and steam trams rushed about in a most confusing way, and natives in swarms (many of them blind) seemed to take a pleasure in strolling in our track, and stupid donkeys and sad-eyed camels with unwieldy loads kept turning about in unexpected directions, and looking at us in a reproachful way, as much as to say they thought bicycles _quite_ out of place in their country. the narrow bridges over the nile were thick with traffic, and i was quite glad when we got out to the open country and on to a good road with trees all along. we left our bicycles at the hotel, and walked out to the great ghizeh pyramids, really a most marvellous sight. the big pyramid covers as much ground as lincoln's inn fields; enormous blocks of stone, apparently just tumbled one on the top of the other, and yet the whole worked into such perfect shape. to think of how they can have brought these vast blocks of stone down, without mechanical help, from upper egypt (for there was no such stone to be found near there) is indeed wonderful. the temple, also, is a thing to marvel at, great blocks of granite and alabaster cut and fitted together so perfectly, the doorway as straight as possible, and to think that all this work was done from to years ago and is still as sound as ever. we had not time to climb the pyramid, but of course we paid our respects to the sphinx, and wished we could stay to see her by moonlight, when she is said to be even more impressive than in the daylight. they gave us a very good lunch on the balcony of the hotel, which is said to be the best managed in egypt; and i should think it would be a very pleasant place to stay at, nice airy rooms and a lovely marble swimming-bath at the back. as we rode back there was a good deal of wind against us, and i was out of practice and rather tired, so i found the crowded streets of cairo alarming, and was much relieved to give up my bicycle without having run over any one or damaged the machine. i think there was more of a crowd than usual, as the khedive had driven to the station to meet the king of siam, and we saw the whole procession pass on their way back to the palace. the king of siam was very gorgeous in a white uniform with much gold lace, and his two sons were a somewhat curious contrast to the natives around, in their eton suits and top-hats; they are going up the nile on a private boat. helouan is beginning to fill up for the season (we were about the first arrivals), and we have many visitors. we are in comfortable lodgings, quite on the outskirts of the village; the servant who chiefly waits upon us is a fine arab with a black moustache, who stalks about in a white night-gown down to his heels, tied round with a red sash; he wears a red fez cap with a blue tassel, and red sandals on his feet; he does most of the housework, for which purpose he puts a housemaid's apron with a bib over his night-gown! his name is "abdul" (the "slave of god"); and there is a small arab boy called "ishmael," who runs messages, and is most interested in our doings. the mosquitoes are pretty bad at night here, and we have to sleep in nets. last week we had two days with a south wind blowing, and then the beasts--creeping, crawling, and flying--_were_ a trial; there were great wasps (quite three times as large as english ones), and horrid little beasts that look like bugs (only they fly and don't bite) settling on our dinner-table;--i am sure the south wind must have been blowing in the time of the plagues of egypt! i am busy collecting things that we want to take up the nile for our house, as we shall then be miles from the nearest shop, and it is rather difficult, as i don't know at all what the house is like. there are so many things that i should like to do and see in cairo, but i have not time, as we are leaving by the first tourist steamer that goes up the nile, and i don't like to be out for any length of time, but i did manage a visit to the great native hospital, the kasr-el-aini, where i know several of the sisters. it is a very fine place with a very up-to-date theatre; the nurses are all natives (men for the male patients), but they all work under the english sisters. the sisters have a most delightful home, their dining and drawing rooms are very spacious apartments, and they each have a very large room, which most of them screen off into bed and sitting rooms. there is a special fund which provides a carriage and pair for their use, and they have a very good tennis court in their garden, in which they are "at home" one day each week, and the cairo people go to tea with them and to play tennis. i have not told you a word about the native bazaars and all the quaint sights of the cairo streets, but every one writes about them, and i find them too dazzling to describe. i could sit for hours on the balcony at shepherd's hotel just doing nothing but watch the people. take my advice, and come to see cairo some day, for it is a most fascinating place, and i am quite loth to leave it. xx luxor, upper egypt, _december _. once more we have moved our camp, and though we managed the move with very little exertion for my patient, and are now settled in very comfortable quarters here, and he is pleased to be amongst old friends and in his old haunts, and the climate is perfectly beautiful, still it is sad to see that he is going downhill; so it has been arranged for his mother and younger brother to join us here, and we are counting the days till they arrive. we came up the nile on _rameses iii._, the newest of cook's tourist steamers, a very comfortable boat with nice airy cabins. i took all our baggage on board in cairo, but we had agreed it was better to avoid the noise and bustle of embarking in cairo, and that we should join the boat when she anchored a few miles away from helouan, at a place called badrachin. two of our doctor friends had meant to come to see us safely on board, but at the last moment they were both prevented, so we started off in an arabeyeh, escorted by a policeman mounted on a donkey, who had been sent to give us any help he could. much to my anxiety, before we had gone far, the sun had disappeared, and a sand-storm had got up, and by the time we had reached the nile it was quite cold, and the water was very rough with white waves showing. _rameses iii._ was anchored at sakkarah on the other side of the river, but our policeman rode on and signalled to them, and as soon as they saw us they sent off a boat to take us across; it was rather a perilous trip as the boat was a light one, and we shipped a good deal of water. i was thankful when we got safely on board, and found a good doctor and other friends to help us. the tourists--of whom there were not many, as this was the first trip of the season--were all away sightseeing at the sakkarah pyramids. strolling up the river on these steamers is a very pleasant way of travelling. though the banks of the nile are flat and there is a certain sameness about them, the lights are so wonderful that they never _look_ the same. i used to think that the only thing that it was really worth while having to get up early for was a day's hunting, but now i must add the sight of the sunrise on the nile, and as for the sunsets they are simply gorgeous, the intense red, gold, and orange as the sun sinks with the delicate blue above; and then you turn your back on the sun and face the rich indigo blue of the afterglow, and then in a few minutes it is all dark (no twilight here), and there is a solemn hush over everything. the steamers don't travel at night, and they stop at various points where there are interesting things to be seen, and then all the tourists troop off and mount the excellent donkeys, who seem to think nothing of the heaviest weights, but canter off to the tombs or the temples as though they quite enjoyed it. i had a very good ride on a big donkey called mahomet to the tombs of beni hassan, and another day i went ashore and had a good look round assiout. on the morning of november i had a long ride out to see the temple of dinderah (a very beautiful temple), and then the same evening we reached luxor just at sunset, and walked up an avenue of palm-trees to the hotel, which just at this season is very empty, so we have large rooms on the ground floor, and there is a delightful garden, where at present we spend most of the day. we have a little house just across the road facing the hotel, and i am very busy getting it ready. as i am the only nurse here, if any visitors should come up ill, i should have to look after them; but so far people are behaving nicely. we have secured two good arab boys as servants--hassan and girgus. hassan can speak a little english, but girgus cannot, and it takes a long time to get much work out of people when you can't talk to them! you would be amused to see me wrestling with arab carpenters, who seem quite incapable of putting anything up straight, and with arab painters, who never get the same colour for two days together. the chaplain's wife, who came up the river with us, has gone on to assouan for a few days, and as she has left me her donkey to use, i get a little exercise every afternoon. the other day i had rather an amusing time. i had ridden out to karnak with miss l. to see the temple: it was very dusty, and we were very hot; and when we got into the shade of the temple we saw a party of people having tea, with two men in very gorgeous uniforms waiting upon them and a dignified dragoman standing by. i recognised the dragoman as one of cook's men who had helped us in cairo, and he gave me a sweeping bow as we passed. i said to miss l. as we moved away, "i am sure that nice dragoman would like to offer us some tea, and i do want some very badly," and we had not gone very far when the dragoman came after us with a visiting card and "sir g. n.'s compliments, and would the ladies accept a cup of tea?" so we joined the party and had a most pleasant tea, the dragoman having evidently explained who we were. they had come up on a dahabeah, and were staying only for one night now, but may return later on. they told us they thought they _must_ ride camels in egypt, so at keneh they all started off on camels, each with a boy attendant on a donkey, but all except one of the party returned on the donkeys, with the boys on the camels! the karnak temple is very beautiful; i have been to see it several times now, and find something new to gaze at every time i go; once i visited it by moonlight, and then it was most solemn. there is a very nice little hospital for natives in luxor, where they do a good many eye and other operations. the native doctor in charge has been most kind in lending me his horse, a perfect little arab that goes like the wind, and i have had some delightful gallops on the desert. all the houses in luxor are built of mud, or mud bricks, the bigger ones being colour-washed over, but often you see a little bit of straw sticking through the colour-wash just to remind you that it is "a house of straw." we are building a little summer-house out at karnak, and sometimes drive out there with our lunch and spend the day--the air is fresher away from the village and the cultivated land; and one of the engineers who is building the railway from cairo to assouan sometimes lends us his trolley on the line, and a couple of arabs shove us (with hassan in attendance) several miles out into the desert. we also do some sailing on the nile when there is any wind. _rameses iii._ stayed here a few days on her way down the river, and most of the passengers came to look us up. one evening they had a fancy dress ball on board. i went down for a little while, and it was such a pretty sight; the boat was moored close in, so that they could dance on deck and then stroll in the hotel grounds, and it was all lit up with japanese lanterns, and looked so pretty with the palms waving above. there was a gymkhana one day, and it was very good fun; camel races and buffalo races and all varieties of donkey races; one very amusing race was for gentlemen riding one donkey and driving another with long reins in front of him. the leaders would seldom go straight, and they got hopelessly mixed up in the reins, and had to be disentangled several times. a favourite amusement here is to play hare and hounds on donkeys. they have quite a big meet of hounds near the hotel, and the hares (three of them) have a long start to give them time to ride out to karnak, and then they have to try to ride back to the racecourse without being caught. the hounds are divided into three packs--the fast, the medium, and the slow; the master has to be a man of tact: he sends off with the fast pack the keen young tourists, many of them americans, the men riding in their shirt sleeves, and they gallop out to the boundary to drive the hares in; then the medium pack trot out in a business-like way, ladies and gentlemen, who are probably very correct in their costume for riding in the row, and who would not think of riding at home without a top-hat; and, lastly, the slow pack, consisting of people who (in some cases) hardly know a horse from a donkey, and who solemnly jog down to the racecourse and then loiter about to see the fun when the hares come in. the natives take a great interest in this sport, and call it "hunting the mahdi," but their sympathies seem to be entirely with the hares, and they give them every assistance by scouting about for the hounds, and secreting the hares and their donkeys in their mud houses when there is danger about. dr. r. and i were the hares one day, and we had a most exciting ride, but were caught at last just as we reached the racecourse. at one point i was hustled into a native house (just mud walls with no proper roof), and found a buffalo being milked in one corner and a baby lying on the ground in another, and from there i watched half-a-dozen hounds gallop past, thinking they were close on my heels, and when they got out of sight i doubled off in another direction. the donkeys seem quite to enter into the fun of the thing, and do their best, but sometimes they get excited and bray--inexcusable behaviour, which is most disconcerting when you are trying to hide in a patch of sugar-cane! xxi luxor, upper egypt, _january _. it was difficult for us to realise the snow and cold that you had for christmas, while we were enjoying perpetual sunshine here. my patient is now established in his little mud house, just across the road from this hotel. i am thankful to say his mother and brother have arrived, so we share the nursing between us. it has been downhill work lately, and now he seldom leaves his bedroom, a large "upper chamber" with a nice view over the palm-trees to the nile. the nurse from assouan has come down to be with him at night, as i have been annexed by a poor lady in the hotel who is desperately ill; she came up from cairo with a very bad throat, and now that is better, but she is still very ill, and it is not quite clear whether it is typhoid fever or general pyæmia, but i am afraid, whatever it is, her strength cannot hold out much longer. i am with her for all the nights and part of the days, and go backwards and forwards to the house, and get some sleep in just when i can. there has been much excitement here about the rumour of war in the soudan, and now it is more than rumour, and the troops are being pushed up country as fast as they can. cook's people are in great trouble, as all their tourists going down to cairo have had to be turned off the boats at naghamadi (the present railroad head), and they have to go the rest of the way down by train, while the boats turn back to take the troops up to assouan. some regiments are being sent all the way by rail, in spite of the line not being yet finished. the engineers are working day and night. i met one of them just now, who said he was up to his eyes in work, and that he had twenty telegrams in his pocket, all different orders, and each contradicting the one before; so i said i supposed he did what he thought was right and hoped for the best! they have been busy here with an old tub of a steamer that has been used for years as a landing stage; with much tinkering at last they got the engines to work, and now she has gone wobbling down the nile to bring up stores. it was exciting when they first lit up the fires, as i hear she ran away and knocked pieces out of the road on the front. the oxfordshire and lincolnshire regiments have gone past, the men packed like sardines in the boats. i badly want to go up with them, but at present they don't seem to be sending any sisters, and my work is cut out for me here just at present. all the steamers that come up, besides being heavily loaded, are towing large barges with either men or stores in them, so there is a good deal of delay about our mails, &c. i expect you hear more of what is going on at the front than we do, as all the wires are blocked with service messages, and we hear only rumours; to-day we hear our troops have had a bad smash up near berber, and that they have lost a gunboat, but whether there is any truth in it or not is very doubtful. to-day the camerons are passing through here, and the natives are much excited at the kilts. i think they rather imagine that england has run out of men and has begun to send the women! somehow life seems very strange here just now; for one thing, there is the rustle and bustle of war in the air, then, at the same time, in this little place we are already having a stern fight against the enemy of disease, and all the time there are tourists filling up the hotel and making merry, and you hear them talk of the luxor meet of the sporting club, and which donkey they will secure as their mount, as though it was the most important thing in the world. until last week i still went for a ride now and then by way of refreshment. there is a doctor here who rides an enormous white syrian horse, and he was most kind in bringing me a beautiful little arab, and taking me out for a gallop when i could get away; the arab was too quick for the syrian, and often, having let it go, i had to wait for him afterwards. one day we were coming in from the desert and passed our chaplain, who afterwards amused my friends by telling them that i had passed him at such a pace on the arab that the wind i made nearly blew him off his donkey, and then about a mile behind something thundered past that at first he thought was a white elephant but afterwards concluded it was a watering-pot of a new fashion, as it left such a track of damp on the sand! one day the german consul took me to see his collection of curios (i believe he does a good deal of trading in them): he has got a splendid collection. i had to drink native coffee--which i can't abide--but before i left he gave me a beautiful little "antique," a little blue image that was found in a tomb near here, and probably dates from about b.c., so i forgave him the coffee! the other day miss c., the housekeeper at the hotel, knocked up with dysentery, and was very seedy for a few days. before she got well again there was an urgent call for more steamers for troops; so the steamer _rameses the great_, that happened to be moored here (meaning to stay four days while the passengers explored the place), suddenly had to turn all her passengers and their baggage off into the hotels and leave them there, while she did a trip up to assouan and back. the hotel was simply packed for five days, and the noise was very bad for our sick ones; poor miss c. was frantic at not being able to get about and see about rooms, &c., for all these people, so i had to do what i could to help her, but i was frightfully busy with so many ill. the nile is getting very low and "smelly," and we hear that they have several cases of dysentery at assouan, and there is a poor lady somewhere up the river on a dahabeah very ill with it, and there is no nurse within reach free to go to her. with all this urgent traffic on the river it is difficult to get things up from cairo (even urgent "medical comforts"), and you cannot imagine how many things one finds lacking for the sick ones from day to day, when you are miles from the nearest chemist's shop, with uncertain communication by post or telegraph. i am always making raids on the little hospital, and the doctor there is most kind in helping us, but he is short of some things that he needs himself and cannot get--for one thing, the supply of chloroform is very nearly exhausted. we sent an urgent message (telegraph not available) by the last boat going up to assouan, and we hope the doctor there may be able to lend us some for the present. it seems weeks since i have had a night in bed; my poor lady is so ill that i can hardly leave her, and i just sleep in an arm-chair in her room when her husband sits by her for a time. the arab servants, especially hassan and girgus, are wonderfully attentive and good--in fact, all help us as much as they possibly can; but with people so desperately ill one does long for london, and the best physicians, and the best nurses to help one. it is not possible to do all one would wish for several patients at once both night and day; and having had so little sleep of late i am afraid of forgetting things, and i have to write all the orders down and tick them off as i carry them out. this letter has been written in scraps, and i am finishing it as i sit by poor mrs. ----; i must keep awake somehow till her husband wakes, then he will watch while i have a nap. i fear it is quite hopeless, and she has been unconscious for some hours now, so i cannot leave the poor man alone with her. xxii paris, _march _. you would gather from my last letter that we were having a sad and trying time at luxor, and after i posted to you we had so much more of sadness and sorrow that it seems like a bad dream, and i can't write much about it. the poor lady died of pyæmia, and a few days later my patient was laid to rest in the little cemetery out in the desert that he loved so well. all the winter the tourists had been so fit and well up the nile (fortunately for me), but in january every one seemed to get ill, and they had quite an outbreak of dysentery. it began up at assouan, but two poor young ladies (travelling with a young brother) became very ill between assouan and luxor, and were carried ashore and brought to the hotel. our night nurse went off to nurse them, and as soon as i was free i had to go straight on to help her, as they were both desperately ill. it was my first experience of tropical dysentery, and in some ways it seemed almost more like cholera--nothing seemed to check it. a very good physician came up from cairo, and stayed some days trying everything to save them, and nurse and i were working night and day, but it was no use, and they both died within twenty-four hours of each other. then others got bad, and we had to go from room to room doing what we could for them, and wishing we either had half-a-dozen nurses, or else had all our patients in one hospital ward. gradually the others all began to improve, and we were beginning to think of going home, when i was telegraphed for to go up to assouan to nurse the bishop of ----, who was very ill; the nurse who was stationed up there also being laid up with dysentery. i was not pleased at having to go, as we were just packing up to travel home, clearing up the house, &c., and i was feeling very done up, but i could not well refuse, as there was no other nurse within reach; so i went off by the post boat, and spent most of the two days on board in sleeping, as i did not know how much work might be waiting for me, and i had a good deal to make up in the way of sleep. i find from my diary that between the th of january and the rd of february i had never had a complete night in bed, and sometimes even the odd hours of sleep were very few and far between. but when i got to assouan i found that every one was on the mend, and they hardly needed a nurse, so i stayed only a few days to help (and managed to explore philæ one afternoon), and then i left again by post boat for cairo, the doctor putting a lady, who had been very ill with dysentery, under my care, and giving me a little stock of medicines to use at my discretion, as the post boats--unlike the tourist boats--carry no doctor. we stayed an hour or two at luxor, so that i managed to collect my baggage and said many good-byes. all the inhabitants--including the servant boys and the donkey boys--seemed to be there to see us off, and they had all been so very kind to me through a very trying winter that i felt as though i had known them for years. there were pleasant people on board the boat, and the gentleman sitting next to me at table knew kimberley well, and knew my brother out there, so we had much talk about south africa. the boat was simply packed; and, as it was getting very hot, every one wanted to rush down the river at the same time. there were supposed to be thirty-two first-class berths, and the manager told me that there were fifty-five passengers on board--men sleeping in all the bathrooms, and the saloon full at night. i had a sort of little dog-kennel to myself in the second-class--not a bad little hole when i got there, but to get to it each time i had to cross the lower deck, where all the native passengers live and sleep. my sick lady improved as we got down the river, and it was very lucky she did, as before we reached cairo i became seedy with dysentery myself, and had to consume some of the drugs the assouan doctor had given me in case of need. the last day on board was exciting, as the nile was so low we kept banging on to sandbanks, and all the glasses were broken; and as many of the passengers had only just allowed time to catch their ship at alexandria, there was much anxiety lest we should stick fast. i saw my lady patient safely into good hands at mena house, and then just caught my friends in cairo (they had gone down from luxor when i went up to assouan), and after getting some advice from one of our good medical friends there, we went straight on to join our ship at alexandria. when i got on board i felt so absolutely done up, i had to turn straight into my berth, and the ship's doctor took me in charge. i believe he rather thought i was in for typhoid, and wanted us to go on to venice with them, so that he could look after me for a bit longer (as they stay some days at venice), but three days' rest at sea and some medicines pulled me together a bit, and i did not want to upset plans. we landed at brindisi, and spent an uncomfortable night in a hotel, because we found the sheets were very wet, and felt obliged to sleep in blankets, a thing i never enjoy. from there we had a train journey of eleven hours to naples, and we did an idiotic thing, for which we have not forgiven ourselves yet: we got up at . a.m., thinking our train started at a.m., and when we got to the station found that our tickets were made out to travel by another route, and the train did not leave till . a.m.! naples was perfectly beautiful; from our windows such a glorious view of the bay and of vesuvius in the distance. we could not go up vesuvius as he was rather "active" just then, and some people who went up the day we arrived nearly got burnt with some hot lava. we went one day by steamer to sorrento (a place i should like to stay at some day), and then over to capri, and we explored the wonderful blue grotto there. capri is a sweet place, with such lovely flowers and ferns. another day we spent at pompeii, and wished we could spare more time for exploring the museum in naples, where most of the best things from pompeii are now shown; and then a drive we took along the bay to posilipo is one of the most beautiful drives i have ever enjoyed. from naples we moved on to rome. it is quite hopeless to try to "see" rome in anything under a month at least, so we did not try. the place seemed to be full of our egyptian friends, and we met them at every turn, so we had a very pleasant time there, and of course we did see _some_ of the sights. we spent some time at st. peter's and several more of the wonderful churches, and we explored the colosseum, and the forum, and the thermæ caracalla, and we went down some catacombs (and were very glad to get safely up again!); in fact, we saw just enough to make us wish to return some day with time (and money) to enjoy it all more fully. we then moved on to florence and had a few most enjoyable days there; the picture galleries were most fascinating--so many pictures that one has known and loved all one's life (from photographs), and will now love all the more for having seen the originals. the town is very interesting, and the surrounding country is lovely. our last day in florence was wet. this was disappointing, but as it was the first rain i had seen since last september i could hardly complain. we spent a night in the train, and then stayed a few hours in milan, just to see the very beautiful cathedral, and then got on board a corridor train to cross the st. gothard. near milan the fields were thick with primroses and anemones, and it was quite hot, but we soon got up amongst the snow, and then the scenery was simply grand. we stayed a few days with some swiss friends in zürich. they have a delightful house looking over the lake, and the snow mountains in the distance are such a restful sight. one day we went out by train, and then did a little climbing, and got up amongst the snow: it was so funny after all the scorching we have had just lately. from there we travelled by night on to paris; and now we have come to the end of our "saunter" across the continent, and i am sure it has done us all good, and has been most refreshing. i have just been out to get my hair shampooed, and i think i have now got rid of the last remains of egyptian dust. to-morrow we make tracks for england, and then i don't quite know what is to be my next move, but more work, i hope, of some kind or another. xxiii general hospital, london, _january _. i don't think i have written to you since i slipped back into my work here. we got back from egypt in april, and i spent a little time at home and paid a few visits, and then the matron asked me if i would return to take charge of one of the women's surgical wards for four months while the sister was away on sick leave; so back i came at the beginning of july, and it seems as though i am likely to remain. i had such a nice welcome back from every one (from the surgeons down to the porters), that i soon felt quite at home again. at first it was rather strange, as they have changed the "off duty" times, and all the nurses get more time off, so that means you have more nurses, and when they were all on together it seemed such a crowd to me: in that ward for twenty-two beds and four cots i had a staff nurse, a senior probationer, and three other probationers, and two lady pupils, seven besides myself on day duty and a staff nurse and a probationer on night duty; but it is seldom they are all on at the same time, and i have to run around and see that those who are on attend to the work of those who are off, and that things are not neglected because "it is not my work"! it is nice for the nurses not to be so rushed as we used to be, but i am not quite sure that it is such good training; i don't think they feel quite so personally responsible for their patients' welfare as they did when there was no one equally responsible with them; it is rather difficult to explain exactly what i mean--for one thing, the staff nurses now have two days off together each month, so we have a senior probationer who takes over their work for those two days, and i find they get much more out of touch with what has been ordered for the patients than they did when they were away only for one day; but i am getting used to it now. the ward i had when i first came back was rather dingy, and i regretted all the nice flower-pots and vases i had left behind in the ward i had when i was last here, to say nothing of my nice stock of children's clothes (i had heaps of white sailor blouse tops for the small boys, and muslin pinafores for the little girls, with pale blue frocks to wear under the pinafores on high days and holidays); but i did not spend much on vanities in that ward, as it was not worth while for a short time, and the more fancy things you have the more it costs you in washing, as the hospital won't pay for vanities, though it does make a difference to the look of your ward when visitors go round, and the mothers just love to see their poor little kiddies dressed up "like a real little lady" instead of in flannelette! i liked both the night and the day staff nurse in that ward, and they were very nice to me (sometimes staff nurses are _not_ nice to a sister doing temporary work, as they often think they might have been allowed to do the sister's work themselves). the ward had been noted for never being without squalling babies, and i was rather amused to hear from another old nurse of mine that these staff nurses had learnt that i was very particular about tidiness, and very anxious that the babies should have no reasonable excuse for squalling; so they were determined to try to please me in those respects. one day i came down from the theatre (after being up for several operations) just at tea-time, and i thought the ward looked rather untidy, but i wanted my tea so badly and the ward-maid had it all ready for me, so, after taking a look at the operation cases, i--rather unwisely--concluded i would drink it before going round to tidy up, and, of course, before i had finished tea the matron came in, and i had to escort her round, inwardly fuming at some crumbs by a child's cot, and some of the trays brought down from the theatre and not put tidily away; but matron was very amiable, and when we got to the door she said, "sister, i never remember seeing the ward so trim and neat after a theatre afternoon, and not a single baby squalling!"--so of course i told the staff nurse, and she was mightily pleased. we had had a curious case in the theatre that afternoon--a poor little scrap of a baby, one day old, born with an imperforate anus; as soon as they began to give it an anæsthetic it stopped breathing, and after trying to revive it for some time the surgeon put on his coat and went away, but we continued doing artificial respiration, and eventually the child came round; so another surgeon (who was still in the hospital) came in, and he advised the house surgeon to do colostomy, which he did very rapidly, and the poor little mite was relieved, but it only lived a day. we had a first-rate house surgeon on just then, and he looked after his dressers well. you have no idea how slack and lazy the dressers sometimes get if the house surgeon is not keen, and it makes a vast difference to the patients' comfort. it happened to be our "take in" week when bank holiday came, and we had a very lively week. altogether we took in sixteen cases, but a few of them were injuries to arms or fingers, so they were able to go out again after a night or two, thus leaving beds free for others. on bank holiday itself things were pretty quiet until the evening, and then we had four accidents in two hours--an old lady of seventy-nine with a fractured femur, a baby with a scalp wound (fell from its chair on to the fender), a little child badly scalded, and a very big and fat woman with a fractured tibia and fibula, who, i was horrified to find, was expecting a baby to arrive very shortly, and as none of my nurses had had any experience of such things, nor had the present night sister, i felt obliged to keep within hail both night and day; but one sunday i thought it seemed safe to go out to church, and another sister promised to attend if required, and sure enough she _was_ required, but all went well, and the mother made a good recovery, and i think was rather pleased to go out with a fine healthy baby, having been saved all the expense of her confinement. when the sister of that ward returned, there was a small men's accident ward vacant, so i was offered that until a larger ward should be free. i was sorry to leave the children, but the new ward was under the surgeons for whom i had worked before i went to egypt, and i was glad to be on for them again. it was november when i moved my camp, and i seemed to have hardly had time to turn round before christmas was upon us, and a very bright and cheery christmas we had, in spite of the fact that we were "taking in," and the cases simply streamed in. altogether we admitted twenty-one cases during the week for our twenty beds. of course some kept going out, but we had to send our most movable patients to sleep in other wards, so as to keep a bed always ready for the next accident. amongst the cases we had two poor fellows who had cut their throats; one a lad of twenty-one who had had influenza, and the other a man of thirty-two who had been jilted by a girl. they both had tracheotomy done, and both did pretty well at first, but i don't think the younger man wanted to get better, and eventually he got pneumonia and died. the other man got all right again. all through christmas week they both had policemen sitting by them in case they should attempt suicide again, and these policemen were most useful in helping with the decorations. at the same time we had a big drayman in, who had fallen off his dray and got slight concussion of the brain. he did not get quite sensible for some time (though he was never very ill), and he was always trying to get out of bed, and whenever any one got up on the ladders to do a little decorating there would be a call that "no. was getting out," and we all had to run to put him back and tuck him up again. these various interruptions made our decorations a very slow process, but eventually the ward looked very nice, and i think the patients had a very happy christmas; even the two poor cut-throat men seemed quite pleased and interested in their presents, though they were neither of them able to enjoy the privilege of a smoke, which all the other men (including the policemen) so much enjoyed on christmas day. one man who came in with a damaged knee told me that he was a rival "strong man" to sandow; and, as he was verging on delirium tremens for some days, we felt a little anxious until he calmed down; but he proved to be quite a nice patient. xxiv general hospital, london, _december _. i seem to have been wasting a lot of time this year in being seedy in one way or another, so i don't think that i have much of interest to write to you about, and now that the war in south africa is making us all excited (as every one feels as if he ought to lend a hand), it is difficult to think of the trifles that have been filling up our lives for the last few months. after i wrote to you last, we had in yet another cut-throat who proved to be a lunatic, and he gave us a very lively time before we got him well enough to despatch to an asylum. one day he jumped out of bed in a great hurry (as he was very fond of doing if the policeman in charge took his eye off him for a minute), so the man in the next bed called out "halloa, mate, where are you off to?" to which he replied, "i've got a second-class pass for heaven, so i'm off," and it took some persuasion before he would believe that the train for that destination was not due yet. another night he proposed to the night nurse, as he thought they might get on well in "the fried fish line" together! it is strange how nervous men are with any one a little bit "off": even some of these big policemen always call out for us to come if a man gets restless. i am not a bit afraid of them, and can generally get them to do what i want with a little chaff; but i am heartily tired of having cut-throats in the ward: i seem to have had so many of them at one time or another, and they are a great anxiety. we had so many accidents in from the railway station near by last winter that the superintendent very kindly told me (as one of the accident sisters) i might have a free pass any week-end that i liked to apply for it to any station on their line; so i had a very good time going to visit friends and relations at the seaside when i was able to get away from saturday to monday; and they were first-class passes too, so that one could go by the fastest trains. one evening in may i found that a lad, who had been brought in with a broken leg, was peeling nicely all over, and we extracted a history that _might_ have meant a slight attack of scarlet fever, but it was so indefinite that the house surgeon did not believe it, and did not have him moved at once; and two days later another small boy developed scarlet fever, and then one of the nurses, and they began to talk about closing the ward; then one day i had a raging headache, but did not think anything of it, but when i went to bed (much to my disgust) i found i had a brilliant rash; and the next day the doctor came along and agreed in my diagnosis of scarlet fever, and offered to isolate me there or send me to the london fever hospital (paying), but i thought i would just as soon sample an ordinary m. a. b. hospital, so i took my departure in state in the fever ambulance, with a crowd of friends to see me off--from a safe distance--at the door. they made me very comfortable at the fever hospital, but i felt rather a fraud, as i had the fever so very mildly that i was never ill at all: no sore throat and no temperature after the first two days--in fact i think they doubted whether i had ever had it at all, and it was very slow work waiting to peel. having at last accomplished this process, i went back to the hospital to clear up my rooms, as a larger ward was going to be vacant soon, and matron wanted me to have it after i had taken a holiday. so i had a good time at home in the best of the summer weather, and paid a few visits, going down to the isle of wight and having some splendid bathing and boating there; but it is strange how it takes it out of one having scarlet fever, even when you have it as ridiculously mildly as i did, and i had a good deal of trouble with swollen feet and other forms of feebleness. in july i attended a very pleasant function at marlborough house, when the princess of wales presented me with my certificate of membership of the royal national pension fund for nurses, and i met many old friends amongst the one thousand odd nurses who were there. it was a scorching hot day, and there were some active non-commissioned officers of the scots guards who had their work cut out in marshalling the crowd of nurses for their march past; and we found it warm work standing in the sun, as we were wearing indoor uniform, and our caps were not much protection; but as soon as that was over we found plenty of shade under the beautiful trees, and were provided with ices and delicious plates of fruit and other refreshments. i knew a member of the household, and she very kindly took me round some of the royal apartments, and it was interesting to peep into the cool dining-room, with the lunch ready laid for the royalties to partake of as soon as they had dismissed us, but they stayed chatting with some of the nurses for some time, and altogether we spent a very pleasant time there. as i was travelling home afterwards in an express train we were suddenly pulled up with a tremendous jerk that threw us and our baggage about the carriage, and when we had picked ourselves up and could look out of the window, we discovered that our carriage was on fire. fortunately a signalman had noticed it, and telegraphed to the next signal-box to stop the train; we all had to bundle out at a country siding, and the carriage was taken off to be attended to by the men there, while we and our baggage were packed into the rest of the train--which already seemed quite full--and then we hurried on again; but if the signalman had not noticed it, it might have been very unpleasant for us. i went back to work early in august, and when i got to the hospital the doctor who generally looks after me was away. it never struck me that i needed to see a doctor, and the matron did not think to suggest it, so i took over my new ward and began to get things into shape and to my liking. it seemed to me that it was very hard work, but i just put it down to the fact that the weather was very hot, and that i had been slacking for so long; and i thought i must pull myself together; but in about a fortnight the doctor returned, and next day he came to see me and said i was not fit for work yet; so, much to my disgust, i was bundled off for more rest. towards the end of september i again got into harness, worked for about a fortnight, and then knocked up with acute neuritis in my head, with herpes, &c. i _was_ cross, but the pain in my head was too bad for me to worry about anything else. i was warded in a medical ward, given big doses of morphia at pretty frequent intervals, and generally fussed over, as i had the honour of being a "very interesting and unusual case." when my head got better the pain started down my legs--sciatica--so they kept me in bed for some time, and when i got up i was rather a wreck, and they said i must go south; so once more i went off to stay with some relations near southampton, and it was the middle of november before i eventually got back to work. just fancy having to take from may to november to get over scarlet fever and its effects, especially when the fever lasted only about a couple of days. of course every one who came to see me after i got back, wanted to know how long i had been at work, as they supposed i should be sent off duty for something else before i had worked a fortnight! while i was down near southampton, i went once or twice to the docks to see the first troops going off to south africa. the men looked very fit and trim in their new khaki suits, but they were very tight packed on the troopships and liners. one day i saw the _kildonan castle_ off with men on board; crowds of people to see them off, and _such_ cheering and singing of "auld lang syne" and "god save the queen." some of them looked such boys to go out and rough it at the front, and it is sad to think that they can't all come back--one wonders how many? i wish i could go too. opinions seem divided as to whether the war will soon be over or not. xxv r.m.s. "tantallon castle," _march _. i couldn't stand it any longer; all my friends were going off to the front; and, though many people said the war would be over before they landed, we kept hearing accounts of how bad the enteric was, and that the nurses were being overworked, so i felt i must at least offer to lend a hand. i was afraid if i sent in my papers in the ordinary way i might get sent to a home station to free some army sister to go out, and that would not have suited me at all, so i thought i would go down to the war office, and see for myself if i could get sent to the front. about the middle of january i boldly went down and asked to see the secretary of the army medical department. i quite expected to be told i could not do so without an appointment, but i think the orderly must have thought i _had_ an appointment, for he showed me into a waiting-room, and there a strange thing happened: there were several people waiting, and amongst them a gentleman whose face i thought i knew, but i could not remember where i had met him before. after a few minutes he came up to me and said, "i think you are miss l.?" and i said i had been trying to think whether we had met before, and where? and then he reminded me of how we had travelled down the nile on the same post boat in , and had talked of south africa then, as he knew of my brother out there. then he said, "but what do you want here?" and i replied, "like every one else, i want to get sent out to the cape." after he had meditated for a few minutes he said, "well, i'm offering to give them a field hospital of one hundred beds, and to run it for three months at the cape. if they accept it, will you go with it?" of course i said i would like a shot; and then he was sent for to see the secretary, and i waited and waited, and thought he must have forgotten all about me; but at last an orderly came to say, "the secretary wished to see miss ----," and the people who had been waiting longer than i had glared at me, as i was escorted to the secretary's room. there i found my friend of the nile still talking to the secretary, and the secretary turned to me with a frown, and asked me what i meant by coming down to the war office without an appointment, instead of sending for the application forms in the usual way? so i told him i did not intend to apply in the usual way, and risk being sent to some home station. i had too good a berth in england to give it up for that, but that if i found they would give me a chance of service at the front i would be glad to go and do what i could; that i knew south africa, and knew what to expect in the way of climate, and knew how to manage the native servants, and so on. then he melted a little, and said, "well, this gentleman has been most liberal in offering us a complete hospital, which we are going to accept, and he has asked for you to go with it, so if you will send in your papers and testimonials in the usual way you will stand a very good chance of success." did you ever hear of such a piece of good luck? if i had not gone down personally to the war office, i should never have met my friend of the nile, and if i had even gone five minutes later i should never have met him; and afterwards, if i had seen in the papers about his giving a hospital, i should never have thought of applying to go with it, as, when we met on the nile, i barely knew his name, and should never have connected him with the hospital. i asked him the other day what made him give me this chance on the spur of the moment, and he told me that he did not wish to leave the appointment of the staff entirely to the government, and he did not personally know any fully-trained nurse whom he could ask, and he thought if i had a quarter of the brains he knew my eldest brother to possess i should be a good help to him. i have had heaps of congratulations, as every one says that, though many sisters and nurses have gone from our hospital, this is the best appointment of any that has come our way. i sat up most of that night filling up papers required by the war office, and copying out testimonials to send in with them; also writing home, as i had not even told them i was applying to go. for the next day or two my ward was very heavy with bad cases, and took up most of my time and thoughts; but on the third day i was sent for, and told i was not only accepted but had been appointed lady superintendent, and was to select five sisters to go with me, and send their names in for approval. they hoped we should sail in about three weeks. then followed a very busy time; the authorities of my hospital were most kind in being willing to let me go, but the fact that so many sisters and nurses were leaving for the front was causing a great scarcity of seniors, so i felt obliged to stay as long as i possibly could, only going home for a long week-end to say good-bye. there were shoals of letters (sent for me to deal with) of nurses and others wishing to go with us. some of them were amusing: one was from a viscountess, another from a member of a theatrical troupe; a large proportion of the applicants had had no training, but were "willing to learn"; some offered to pay their own expenses if i would only act as their chaperon--they seemed to think we were going out for a picnic. however, there were plenty of applications from well and fully-trained nurses, and the chief difficulty was to know which to leave out. i had to attend at the war office for an interview with the selection committee. princess christian was one serving on this committee, and she came and shook hands with me and was most kind. all the sisters whose names i had sent in were duly appointed to the army nursing service reserve; and then, having settled the staff, i had to help in choosing the fittings and stores for the hospital, as they wished to take out everything so as to be quite independent when we landed wherever we might be sent. lengthy lists had to be made out of bowls and porringers, thermometers, splints, crutches, charts and chart-cases, syringes, bedding and linen, shirts, suits for convalescents, scrubbing and other brushes, tanks for disinfecting linen, &c. there are so many things that seem to come by nature in england which it would be most trying to find oneself without on the other side. and then there were the food supplies to be ordered: flour, sugar, all groceries, invalid foods, &c.--in fact everything, and enough of everything, to last for at least three months. having chosen all the fittings we could possibly think of, we found great difficulty in getting room on board ship to despatch our cargo, as men were being so urgently called for, and the ships were going out packed with regiments and their baggage. in the intervals of running a heavy surgical ward, selecting sisters, and choosing stores, i had to get my uniform made and buy a suitable kit for a hot climate; i also bought a second-hand saddle (which i knew would be useful wherever we were stationed), and had it packed in a tin-lined case, which took a good many other things inside the saddle, and i thought if we were living in tents the case would be useful to save some of my goods from the white ants. the hours i could give to sleep were few in those weeks, but i shall make up arrears on board ship. we had various false alarms as to the date of sailing, all of which i had to communicate to the sisters and then contradict! i left the hospital on february nd with many regrets, after six years' work, having been a sister, or a night sister, or an assistant matron there for the last five years. we thought we were going to sail at once, but in the end it was decided that the medical officers and the orderlies would have to leave a few days before the sisters. i was sorry for this, as i had hoped to get to know them a little on board ship. before they sailed, mr. x., who was providing the hospital, gave a dinner party to all the staff, and we had a most pleasant evening. after the dinner there was a large reception, and i was introduced to many people whose names are well known both in south africa and in england. the doctors sailed on february th, and on march st i was at the army and navy stores doing a little final shopping when the news came that ladysmith was relieved; the excitement was intense; such cheering and waving of flags, and they set all the musical boxes, &c., to play "rule britannia"! mr. x. had decided to go out with us to see the hospital erected, and on march rd we sailed from southampton on the r.m.s. _tantallon castle_. we have troops on board, and i shall never forget the cheering the people at southampton gave us as we got away. the first-class is full up with officers and some "gentlemen troopers" of the yeomanry. we are now ploughing down the channel with the sea so calm few people can even think of being sea-sick, so i thought i would send you a yarn up-to-date, and then you would understand that it has been impossible for me to come to say good-bye. until we reach cape town, we don't know what our destination will be; in the meantime i am having a good rest, and shall be quite fit for any amount of work by the time we land. i hope to post this at madeira. xxvi durban, natal, _april , _. that was a strange voyage out on the _tantallon castle_. for one thing, instead of the usual mixed lot of passengers, the boat was nearly full of soldiers; there were very few ladies on board besides one army superintendent sister with a batch of sisters and my little party of six, also a few wives of the senior officers; there were practically no old people or children on board. as one would expect, with so many young men on board (many of them mere boys), there was a great deal of fun and joking, and yet beneath it all there was an under-current of solemnity. i think we all felt that it was not possible that we should all return (before we left we heard how many were dying of enteric and dysentery), and we hoped, if we were to be left behind, we should have a chance of doing a bit before we got knocked over. very few of the officers had ever been under fire, and they felt it was going to be a very new experience, and some of them talked of it with awe. i don't mean that they were the least bit "funky," but they wondered whether they would be certain to remember how to manage their men and lead them on as steadily as if they were on parade; some of them thought they would be sure to duck their heads when the bullets were flying, and it would "look so jolly bad." we played the usual games on board, but in the morning the upper decks were given up to the men, who drilled and did physical exercises to keep them fit. at the request of colonel h., we sisters held some classes on "first aid." about thirty officers put down their names as wishing to learn, and attended for half an hour every morning, and we taught them simple bandaging, how to stop hæmorrhage, and how to apply improvised splints, &c. at madeira we could not get much in the way of news from the front, so we supposed that nothing very exciting had happened yet; we had a few hours ashore to stretch our legs, and paid a visit to the fruit market. there was an american man-of-war anchored close to us, and when we left she manned her yards, and the men cheered tremendously, and her band played "rule britannia." there were three deaths on board during the voyage, all reservists, and all from pneumonia; it seemed so awfully sad that they should have given up their homes and everything to come out, and then have got knocked over before they had even seen the enemy or fired a shot. i heard that these men were ill before they came on board, but would not report themselves in case they should be left behind, and they came on board straight from their beds in bitter cold. i have never been to sea in such a crowded ship before; there were four in my cabin, and in a week or two at sea you get to know the good and bad points of your cabin mate's character better than in several months ashore. at our table there was a captain ---- in charge of a company of "gentlemen yeomanry," who were going out, paying all their own expenses: it was rather strange for him having his troopers travelling in the first saloon. he had been in the army, but had given it up because he could not get five months free for hunting, besides some shooting and fishing! there was another captain also at our table who had been a.d.c. to general kitchener in the soudan campaign, and was going out to join him again; he had seen a lot of service, and was very interesting. amongst the soldiers in the third-class there are two district messenger boys going out as trumpeters for the cape mounted rifles. most of the officers and some of the soldiers were inoculated against typhoid during the voyage. but for a scarcity of lymph we also should have been inoculated, to avoid waste of time after our landing, but we gave it up, as it was more important for the men who would probably be sent straight up country. sunday on board was kept very quietly; it was good to see a large attendance at the holy communion service in the early morning, and the parade service was a very hearty one; we had the well-known hymns, "lead, kindly light," and "onward, christian soldiers," and then one that i did not know so well, beginning "o lord, be with us when we sail," and containing the two following verses, which seemed especially appropriate: "if duty calls from threaten'd strife to guard our native shore, and shot and shell are answering fast the booming cannon's roar, be thou the main-guard of our host, till war and danger cease; defend the right, put up the sword, and through the world make peace." the last night on board we had a farewell dinner-party, not sitting at our usual places, but making little parties of our friends. whenever i go for a voyage, i think there is something a little sad when it comes to an end, and we all part and go our different ways, but there was something especially sad in saying good-bye to all these bright young fellows, who had to go off to "face the shot and shell." we landed at cape town on th march, and found that the troopship, with our medical officers on board, had arrived only that morning, though they sailed some days before we did; they had had a good deal of illness on board, and had to send nearly fifty men into hospital at cape town, and they had had two deaths during the voyage. soon after we got into dock i received orders to take our sisters and their baggage up to a boarding-house in roeland street. this we accomplished with the help of the agents, who rejoice in the name of divine, gates & co.; but we had not been established there very long when i received further orders that we should rejoin our ship in a day or two, as our beds were more urgently required round in natal than in cape colony. cape town was in a great state of excitement; martial law was in force, and armed patrols were riding about, and there were constant rumours that the boers were close to the cape. the docks were crowded with men, horses, and stores, all being disembarked, and sent up country as rapidly as possible. i found my brother, who had been on circuit when the war began, and could not get back to his home at kimberley. he had been for some time at the cape, and was shortly going to england. i met a good many friends in cape town; some from kimberley who had come down to recruit after the siege. all the civilians whom i met from there were loud in their appreciation of mr. cecil rhodes and the way he had worked for them and cheered them through the siege--his especial thoughtfulness for the women and children. i took the sisters to see his beautiful house, groot schuur, and to tea with some old friends of mine at kenilworth. i was anxious to see all i could of the military hospitals and how they were managed, as i had had no experience of work for the army; but my first visit to a large military general hospital was not encouraging, as i thought the wards looked dirty and untidy to a degree; the men had portions of food left on their lockers from previous meals, and this food was covered with flies. knowing how much enteric there was in the camp, this, i thought, a great source of danger. the men were cheery, as usual, but complained that sleep was difficult to obtain owing to the live-stock in the beds; in some of the wards the legs of the beds were placed in condensed milk tins (containing some disinfectant), but even this was not always successful. another day i visited the portland hospital, and found everything very trim and the men very comfortable; the sisters had very nice quarters; they seemed rather horrified to hear that we had not brought any english maids with us, as they said they could never get on without theirs in this savage land (four miles from cape town!); but i have had to do with servants out here before, and prefer to manage with natives. i subsequently visited another large general hospital, and found it much better kept than the first one, and the patients more comfortable; so i conclude it depends on the head a good deal, and not so much on the system. a party of wounded men came in while i was there, most of them convalescents, but a few looked rather bad, and it seemed to be a very long time before they were put to bed. i also visited the red cross depot, and saw a good many ladies at work packing bags for the ambulance trains--a suit of pyjamas, a sponge, a handkerchief, a little writing-paper and a pencil, &c., in each bag, which must be a most welcome present for a soldier straight from the veldt. we re-embarked on the same ship on th march, and had a very rough trip up the coast, calling at port elizabeth and east london. at the latter place the weather was very hot with a cloudy sky, and all the officers were in their white suits, when we were suddenly _struck_ by a tremendous rain-storm with thunder and lightning, and the wind howling in the rigging; they had no time to change out of their white clothes, and in a few minutes looked like drowned rats. the steam was up and everything made fast in case we should have to put out to sea, but the storm soon passed over. we reached durban on st march, and now there is much speculation as to where we are to pitch our camp. xxvii pinetown, natal, _april _. when we arrived at durban the town was very full, and the sisters had to stay on board until rooms could be found for them in a boarding-house. late in the afternoon a tug came out with a message that we were to disembark and go to a house called "sea breeze" in smith street. it was rather rough at the anchorage, and we had to get into a basket and were slung over the ship's side into the tug, then the tug had to go round and pick up a lot of lighters that had been supplying other ships with coal, &c., and by the time we got into harbour it was getting dusk, and the customs house, supposing that all the passengers had landed earlier, was closed. i had meant to leave our heavy baggage in the customs house till we knew where we were going; but it was impossible to leave it loose on the jetty, and there were no cabs or trolleys about, but a mob of riksha boys, dressed up in feathers and horns and beads (and very little else), who were all clamouring to be allowed to transport us up town. eventually we piled our baggage on these rikshas, and, distributing the sisters amongst it, we gave the boys the address, and, with much shouting, our cavalcade started off at a trot; we soon reached smith street, but then our troubles began, no one knowing sea breeze; we searched up and down the street, and one old gentleman told me he had lived all his life in smith street, but had never seen a sea breeze there! i tried all the places where i thought our officers might be--the r.a.m.c. depot, hotels, &c.--but could not find them, the sisters all very tired and hungry, and some of them rather nervous; then, by good luck, we met our major, who had come out to see if we were comfortable in our quarters, and discovered that we had been given the name of the wrong street! about p.m. we found the house; but the landlady had given us up, and, thinking we should not land till the morning, had gone out; but some other lodgers (refugees from johannesburg) raided the larder for our benefit, and we thoroughly enjoyed our supper. the next day we found the idea had been to send us up to mooi river, but it was thought that, with the winter coming on, that would be a cold place for sick troops, so we had better be nearer the coast; and then a durban gentleman came forward, and most kindly offered the use of his estate of acres at pinetown; it is only about seventeen miles from durban, but much higher up and more healthy; so the offer was gratefully accepted, and the building was at once begun. then followed a time when we all had to forget that we had come out to "nurse the sick and wounded," and turn to work at other jobs. before they were ready for us to go up to pinetown we were all inoculated against typhoid. it was not a pleasant experience: my temperature went up to °, and i had intense abdominal pain and headache; it seemed like a very concentrated touch of typhoid, but it kept us in bed only two or three days, and the following five or six days we felt as weak as though we had been ill for a month. as soon as possible i went up to see where our hospital was to be built, and found them busy levelling the ground for the tin pavilions. there were three permanent buildings already up on the land; one, we thought, would make a good ward for officers (eight beds); another had a large room we thought would do for our staff mess-room, and some small rooms suitable for medical officers' bedrooms; and the third was a row of rooms that was apportioned for sisters' rooms, and various offices, stores, &c. the orderlies were established in tents a little way off; they were all st. john's ambulance men, and camping out was a new experience for them, so of course they did not know how to make themselves as comfortable as regular soldiers would have done in a new camp. they had joined expecting to have the excitement of stretcher work at the front, and when they were told off to level the ground for the buildings, or to carry up the planks and the heavy boxes from the railway trucks, and to help the builders put up the pavilions, there was a good deal of grumbling. at first the major in command would not hear of our going up to stay until they had got some more of the stores up--beds, sheets, &c.; but when he found how slowly they got on, and how discontented the men were at having to rough it, he gave leave for me to go up with one other sister, as we thought we might help a bit, and, at any rate, could show the men we were willing to take our share. the hospital we had brought out was for one hundred beds, but there was urgent need for more beds, so the p.m.o. had given orders that more huts were to be sent to us, and that we were to open as a two hundred bed hospital. the railway was so hard worked that we had the greatest difficulty to get trucks to bring the building materials up from durban, and the docks at durban were so crowded with stores that it was most difficult to get the things through. some of our medical officers worked nobly at the docks, getting the things packed on to trucks, while the others superintended the unloading at pinetown. every engine seemed to be needed for taking men, horses, stores, water, &c., up to the front, and the only wonder was that so few accidents occurred on the much over-worked single line of rails. we had landed on the last day of march, and on the evening of th april sister ---- and i went up to pinetown by rail, taking all the sisters' heavy baggage; and the other sisters went to give some temporary help on one of the hospital ships at durban, until we could fix up some rooms for them. some of the officers met us at the station, and a fatigue party had brought a truck for our baggage. a tramp of about ten minutes through thick sand brought us to our new abode. our first meal, a kind of supper, was somewhat quaint; a bare deal table in a room dimly lighted by two candles stuck into bottles; plates, knives, and forks had to be used with great economy, as there were not enough to go round; some good salt beef and biscuits and some fruit--and we were waited upon by an orderly in his shirt sleeves, who was an engine-driver when at home in england, and knew more about greasing engines than about cleaning the grease off plates! the weather was very hot, and the officers all looked dead tired, so we soon decided to turn in, and were escorted to our room (in the other building) by the light of a guttering candle, as there were said to be many snakes about. they had found us two beds, and actually some sheets, but absolutely nothing else in our room. however, i hunted up the cook, and he lent me a bucket with some water in, so that we might start fair with a wash in the morning. the next morning we were up before six, and started work in earnest, unpacking cases, sorting stores, and putting them away in different store-rooms, and trying to find the things we were most in need of for household use. some of the hospital fittings had been put ashore at cape town and not yet sent on, and more of the necessaries were still down at durban, so that it was very difficult to push on the building work; and all the time we knew the field hospitals were crowded up, and needing to send men down to us to give them a chance of recovery; and we heard that the generals said they could not fight any more till they could clear the field hospitals. all the cases of stores were numbered, so that when we wanted any particular thing, we had to look up in the list the number of its case, and then hunt about till we found that number; all day long it was "have you seen ?"--"no, i want ." sometimes we found a lot of jugs, and then could not find the basins; sometimes a lot of saucers, and no cups; and it seemed as though we never should get order out of the chaos. at first we had no house-boys, and the orderlies were all busy carrying the building materials up, so sister and i kept the bedrooms tidy, and the medical officers (in return) carried the water for the baths! as soon as i could, i annexed a fine old kaffir as a house-boy, and "john" is a great stand-by now. we tried first of all to fit up rooms with the bare necessary furniture for the rest of the officers and sisters, so that they could all come up and help us. if you saw the jetty at durban you would wonder that any stores ever got sent up to their right destination; literally hundreds of tons of boxes stacked up in hopeless confusion. durban is a bit overdone by military requirements, and quite run out of some stores. on april rd we were made very anxious by a strong rumour that mafeking had fallen. they say that _all_ the little children have died there. yesterday we heard of the loss of a british convoy and five guns, and also that the boers were going into laager again quite near to where cronje was taken. durban is full of refugees, and of ladysmith people recruiting after the siege. i went over one of the hospital ships, the _lismore castle_, before i came up here, and it was melancholy to see the _skeletons_ from ladysmith; one quite young fellow told me he had come here from india, got typhoid soon after the siege began, then, as soon as he began to convalesce, the only food they could give him was mealy meal and a little horse-flesh, so he got dysentery. he is now mending, but it is slow work with them all. before we came, our rooms had been occupied by refugees, and fleas abound; i catch about six _ter die_ and once in the night. luckily we are fairly free from mosquitoes. it is awfully hot, and the medical officers go about in trousers and vests only: we wish we could wear as little! this is a very scrappy letter; we work from a.m. to dusk, and then i have been scribbling a little before turning in, but i am weary to a degree, and must fill up the gaps in my next. xxviii pinetown, natal, _april _. you must not expect me to tell you anything about the progress of the war; the papers here give us very little news; of course we are constantly hearing many startling rumours, but they are frequently contradicted the next day, and probably you have more reliable news of the doings of our troops in your papers at home than we have. so i will just jot down things about our daily work here. we are getting into order by degrees, but at present life is rather a struggle against difficulties. you see we are not quite a civil hospital, nor are we quite a military hospital; for the beds we brought out we were well equipped, and had many more comforts than a military hospital would have been provided with, but now we are to have beds, and our resources are somewhat strained. i found that the mess waiter was in his shirt sleeves because the poor man had been nursing a case of scarlet fever on board ship, and all his kit had to be burnt, so i fitted him up in some pyjama coats to wait at table, until i could get time to go in to durban and buy him some white drill jackets. after a few days' work at unpacking, we got quite civilised in our room fittings, and sent for the other sisters to come up and help. if there had not been such need for hurry in getting the place ready, it would really have been very amusing; much of the furniture had been a good deal damaged on the way, and we all tried our hands at mending--to see our senior surgeon (who is on the staff of a large hospital in england) sitting on the ground trying to fit a leg on to a washstand, or to make a drawer run into a chest of drawers, is a fine sight; i have taken a few snaps with my kodak of the staff in unprofessional garb, and doing unprofessional jobs. i hope they will come out all right, but i don't see much prospect of having time to develop them. the theatre is fitted up, but has not been used yet, and mr. ---- is working hard getting the x-ray room into order, and his apparatus fixed up. our food supplies (always called "skoff" here--the kaffirs' name for food) were very erratic at first. sometimes no meat would turn up, and then we made shift with bully-beef, which is really quite good, or sardines; sometimes no bread, then we used the barrel of biscuits that lived in the mess-room--you have no idea how difficult it is to eat enough of those biscuits to satisfy you (they are nearly as hard as dog biscuits!), and in about half-an-hour you feel starving again; sometimes there is no butter--then marmalade. now things are coming up more regularly, and i hope they will continue to do so, as it is easy for us to joke about short commons for ourselves, but it is no joke when you have sick men needing careful feeding up. one thing is very nice, and that is that the fruit is nearly ripe, and we shall soon have plenty of pineapples and oranges. our cook seems to try to make the best of things; he is only quite a lad, but he is managing to cook for us all (including the men), with only wood under a sort of gridiron, in the open air. there was much joy the other day when we came across a case of "mother's crushed oats"! and nearly all seem to enjoy porridge for breakfast. as it is still very hot, the food supplies are difficult to manage, the meat hardly keeping from one meal to another, even when cooked; and with very limited store-rooms i find it very difficult to see that everything is kept covered up and fly-proof. so far we have had no fresh milk, but now two cows have arrived, and i am having to watch the boys milk them, as we pay for the milk by the number of bottles supplied! we have just heard that the poor old _mexican_ has gone down on her voyage out: no lives lost, but we fear our letters have gone to the bottom with her. one thing i am worried about is that a big tank i had especially asked to have, in which we might boil all the typhoid linen, has been broken on the way, and i don't think i shall be able to get another. we are establishing a place for the washerwomen behind the hospital, on a slope where their water will run away from our direction; i should like to have had a separate place for the staff's washing, but cannot manage it, so must be contented with keeping special women and special tubs, &c., for it. the men are really working very well now, and it is hard work they have to do; they required a good deal of persuasion to work on saturday afternoon; but we hear the field hospitals are crowded up with sick, on this side alone, so we must push on the building. we are getting everything into order in the big store-room, so that as soon as any of the big pavilions are finished we shall have all the fittings quite ready to issue. i have been down to see the p.m.o. in durban. he seems very nice, and willing to give us all the help he can; he seems glad that we are going to have the extra beds, and promises to send us more doctors, sisters, and orderlies; we rather hope that some of the orderlies will be r.a.m.c. men, and that they will put a little backbone into our crew, who, i daresay, will be better when we get into order, but many of them are now rather inclined to say "we didn't pass our exams, and come out here, to do navvies' work." of course i shall be glad to have the larger place, as i know it is so badly needed, but the prospect of seeing sick men properly looked after by these untrained men was alarming, and now the prospect of sick men with more (possibly) untrained orderlies, plus some unknown sisters, is more alarming still; but i suppose we shall shake along somehow. i shall be so glad when the men can get time to cut the long grass round the camp, as there are a good many snakes about (two have been killed quite near my room). we all wear canvas gaiters, as a sort of protection; but there are other weird creatures about, and one night a wire came from the next station to say that a leopard, or some such creature, had carried off a kaffir baby, and we were to look out for the beast; so the men were much excited, but they have not seen anything of him. last sunday was easter sunday, and the men had a much needed day of rest, but the sisters and officers went on most of the day unpacking and sorting the things most urgently needed. we knocked off in the evening, and went to service at the pinetown church. the next day (april th) we had started work as usual, when the sergeant-major's whistle summoned all hands: a wire had come to say that a troop train had been thrown off the line about three miles from here. the major went off with the medical officers and orderlies, with stretchers. i provided them with brandy, water, a mug, a corkscrew, &c., and then hunted up some lint and bandages, and a few splints, and sent them after them. two or three orderlies who were sick in camp came down to see what the alarm meant, and wanted to go to help, but they did not look fit for a three miles' run in the burning sun, so i told them to collect all the natives who were left behind, and we made a hasty clearance of the building that was to be an officers' ward (temporarily used as a store-room). we set several boys to work to scrub the floor and clean the windows, while the orderlies fitted some beds together, and the sisters collected the bedding and made them up, and i got the most necessary ward fittings out of the store, so that when the stretcher party arrived we had quite a workable little surgical ward ready for them. two poor fellows had been killed, and fifteen mules were either dead or had to be shot; three men of the army service corps were injured, one with a badly broken leg, and the others with concussion, &c., and two black mule-drivers had each a dreadfully smashed up arm. the major had a tent pitched for these natives, not far from the ward. it is a wonder they were not killed, as they were in the same truck with the poor mules. one sister and some orderlies were told off to look after these, our first, patients; and then we returned to our building occupations. i did not put a night sister on for these few cases, but i take a prowl round some time during the night (the fleas always wake me up at least once, otherwise i am so tired i don't think i could wake myself), just to see that the orderlies are awake, and managing all right, and the medical officers go round the last thing before turning in, and we are all about by a.m. one of the injured a.s.c. men had been ill before he arrived here, and it looks as though he is in for typhoid. last night, after a more than usually scorching day, we had torrents of rain. the poor orderlies were washed out of their tents, and all their things were soaked. they are not used to roughing it, and don't enjoy it. it seems ever so long since i came up here, but i had been here only four days before these cases came in, and we hope in about another week to be able to send word that we are ready to receive patients from the front. xxix pinetown, natal, _may _. now we are really at work at last, and though i can't say everything is working very smoothly, i think the patients are being well looked after, and i suppose we must expect to have to worry through difficulties for some time to come. on april th the princess christian hospital train brought us fourteen officers and sixteen men, all stretcher cases, and all very ill. they had come from field hospitals, and if one did not know how impossible it is to nurse them or even feed them up there, one would say it was almost murder to have sent them a journey of many hours (over miles) in a jolting train. there were no wounded in this first batch, and i think only about four or five who were not suffering from typhoid in one stage or another, from a few days, up to three weeks or more. it was day and night work for us for the first two or three days, as each man seemed to need individual nursing if he was to have a chance of pulling round; the orderlies (though very willing) had everything to learn of ward duties; they could not even undress these men when they had been lifted on to their beds, much less had they any idea of washing them; a delirious man was a new experience to them, and if he got out of bed and lay on the floor, the orderly would go and ask sister what he had better do! the doctors told us that four of these patients could not live through the first night (several of them had severe hæmorrhage), but they all struggled through that night, and it was a week later when one poor fellow of the royal artillery slipped through our fingers from sheer exhaustion, without ever having become conscious. his mates told us that he had been in a hospital previously with a sunstroke, and had been down with typhoid for some time before he arrived here. i can't describe the condition of these men; they have not had their clothes off for weeks, creeping things are numerous, but we are getting them clean by degrees. those who have been ill some time have sore backs--i can't say "_bed_-sores," as they have had no beds. many of them have come from elandslaagte, and i believe they are very short of both milk and water up there--none of the latter for washing purposes. several of the men had been with us over a week before they became conscious of their surroundings at all; but in the case of those who _were_ conscious, the comforts of a good bed, and a good wash, brought tears of gratitude to their eyes. with many of them it was months since they had slept in a bed: few have done so since they landed in this country, and some of them seem such boys to have gone through so much. i spent a good deal of my time at first helping the sister in the officers' ward, getting her patients washed and made comfortable, and it was most piteous to see these young fellows--most of them, probably, brought up in luxury--so wasted and thin, and _so_ grateful for the little that we could spare time to do for their comfort. lieutenant ---- had been laid up for two months with a bullet in the groin, and is now very ill again with typhoid. captain ----, of the r.a.m.c., had been all through the siege of ladysmith, and had typhoid up there; now he has liver trouble and looks wretchedly ill; i fancy he will have to go home for operation. captain ----, of the royal artillery, was the worst case of typhoid amongst the officers, for some time his temperature persisting in keeping up to and , and he was very delirious; he was always thinking he could see parties of boers, and he told me i was the worst scout he had ever come across, as i did not see them. he is doing well now. lieutenant ----, of the army service corps, had been ill for four weeks with typhoid before he was landed here (still with a very high temperature). he told me that no less than five times had he been moved on a stretcher, from one place to another, as his regiment shifted about, and he said that the order to move always seemed to come in the evening, when his temperature was at its highest, and he was feeling so bad, that at last he begged them to leave him behind to die; they had never been able to give him suitable food, and often not enough of unsuitable, and when at last he got to the line he had miles of jolting over a single-line rail, before he reached us--such treatment for a case that, at home, we should be almost afraid to lift from one bed to another! but he is really mending now, and i hope we shall soon be able to send him home to recruit. i have never had to give so much stimulant to any patients as we have had to give to these men; all the first night i was going round giving milk and brandy, or bovril, to the worst cases, while the night sister sponged those whose temperatures were the highest; several of the men were on ten ounces of brandy for the first few days. they have been so overworked, and underfed, for some months past that they did not seem to have an ounce of strength left to battle with the fever. an army lady superintendent is supposed to take charge of a ward herself--generally the officers' ward; but i have not taken a ward yet, as, until we fill up, there are enough sisters, and it seems more profitable for me to go round supplying the sisters' needs from the stores, looking after the cooking, and the house-boys, and the washerwomen (i fear that my hair will turn grey in my efforts to keep the typhoid linen separate), to say nothing of the cows, which are not a success; and we have had to resort to frozen milk from australia--generally good, but sometimes there is a difficulty about unfreezing it. we have no quartermaster here, and the man in charge of the stores is quite unused to his job, so i have to see to a great many things with which an army lady superintendent has, as a rule, nothing to do. i am very much afraid some of our orderlies will be getting typhoid; of course they find it difficult to realise a danger they can't see, and though we all lecture them about taking precautions, we are so busy ourselves, that it is difficult to enforce them; and just at first there were so many patients quite unconscious and with severe diarrhoea and hæmorrhage, so that it meant constant changing of sheets, &c., by the orderlies. i think i told you some of the orderlies were ill when our first patients (from the train accident) arrived; it proved to be a form of dengue fever they had, and now the medical officers also are indulging in it; it is rather like influenza--high fever for two or three days, and then they are very weak and pulled down for a few more days. i only hope the sisters will refrain from having it until the orderlies have had a little more education: at present they are about as useful as an average ward-maid at home, and the sisters have to act as sister, staff nurse, and probationer too; but i don't want to grumble at them as they are working well, anxious to learn, and very patient with the men (some of them half delirious) who call "orderly, orderly" all day long. if they had had a few r.a.m.c. men amongst them, or even one or two r.a.m.c. ward-masters, it would have been easier; as it is, there is not a single man amongst them who knows anything of the usual routine in a hospital, though they are well up in "first aid" (for which we have no use here). the buildings are getting on, and we are ready for more patients as soon as they can get a train to bring them down. we hear nothing of more medical officers, sisters, or orderlies as yet. one of the men said to me that he did not think any of us could understand what a luxury it was to have a wash, a comfortable bed, and clean clothes; that for months he had been marching and sleeping (in the open) in one suit of clothes, frequently wet through, and remaining wet until the sun came out to dry them; he said that on the high veldt the nights were very cold, and they frequently had nothing but their greatcoats to sleep in; if they were lucky, and the baggage waggons had kept up with them, they would also have a blanket and perhaps a mackintosh sheet; but that the baggage waggons had a habit of getting stuck at the last drift, and then they had only what they carried. if we had only come out to south africa to nurse this one batch of thirty officers and men back to health, i think it would have been worth while, for they were just about as bad as they well could be, and one can't help thinking of the anxiety of their poor friends at home, who will have seen them reported on the "danger lists" from their field hospitals; and we go plodding on night and day trying to make them pull round. only one man has died, and i think the rest will get on, though some of them are still pretty bad. captain ---- had cheyne stokes breathing for two nights, and made us very anxious, but now he is distinctly better. the bishop of pretoria came to lunch with us the other day, and was very nice in visiting the men. we are expecting more men any day now, and on the th of this month we are to be officially "opened" (on princess christian's birthday, i believe); a crowd of people are expected from durban and from pietermaritzburg. i could not help thinking the other day, when all these thirty men were dumped in upon us in a couple of hours, of the old days in london when we thought we had had a very heavy day if six or eight patients were admitted to our ward in a day; and there we had everything ready to hand, and several well-drilled nurses to help. here i can see it will take a little time before the sisters will realise that it is useless to try to have things done just the same as we can at home, and for them to distinguish between the _essentials_ of good nursing, which we must have, and the superfluous finish, which we must do without. xxx pinetown, natal, _june _. we have had a stiff time of work since i wrote last. i think i told you that several orderlies were ill, when our first cases came in, with dengue fever, and soon the medical officers began knocking up with it--first one and then another; next, the sisters took it; no one has been very ill, but the fever was high for several days, and, of course, they were weak and seedy after it went down; so we have not had a full staff at work for some time, and with lots of bad cases in the wards it has made things very difficult. several odd cases have been straying in, and on the th we took in five officers, and then on the th of last month we admitted eight officers and thirty men from modder spruit, most of them very ill, and one poor fellow so bad with hæmorrhage (enteric) that he died the same night. we had to open a second officers' ward, and the sister put in charge was very hopeless (at having so many bad cases, and such inefficient help); so i had to spend a good deal of time helping her look after the worst cases, and then the next morning after they arrived i found she had dengue fever and could not come on duty; so i had to take charge of her ward for a few days, and do the best i could in looking after the patients with the help of the orderlies, amidst constant interruptions and appeals for help or advice from different parts of the camp. with every one so new to the work--the cook quite unused to military ways or the serving of hospital diets, the storekeeper hardly knowing where anything is, or whether he ought to issue it when he did know, ten kaffir women washing who could not read the marks on the linen, and so were quite incapable of returning it to the right place without my assistance, and, to do the house work, several new kaffir boys who really are quite "raw" and want constant looking after (they rejoice in the names of john, monday, charlie, and cup-of-tea; they can speak about six words of english between them, and it is awfully funny hearing the orderlies trying to make them understand), with much other work needing to be done in connection with fitting up new wards and preparing for our opening day ceremony--you can imagine it was difficult to be tied up in one ward with a lot of sick officers who required one's best attention, and more; but it had to be done, and i had to leave the rest to do the best they could, only going round to attend to the most necessary things when i could spare half-an-hour in the day, and after the night sister came on at night. my worst case was poor captain ----, of the ---- dragoons, who was desperately bad from the day he came in, and was delirious most of the time; lieutenant ----, of the same regiment (a friend of his), was very good in sitting with him for part of the day, and when he was at his worst one of the other sisters and i took turns of acting night special (as the night sister could not possibly stay with him much); but he had been thoroughly worn out with the hardships of the campaign before he got the fever, and though he lingered on so that we kept hoping he would pull through, he died on the th of may--our first death amongst the officers, and we all felt very sad. it was terrible for lieutenant ---- (ill with rheumatism), as he knows the captain's relations, and has been cabling to them daily. the funeral was the next day, and the station-master kindly stopped a goods train here, so that the few officer patients who were well enough might go to pinetown to attend, and all the medical officers who could leave also went. i was too busy to go, but i helped lieutenant ---- to make a cross of white flowers to put on the coffin. a thing that always makes me feel creepy when i am working in the store is the sight, in one corner, of a little pile of coffins that have been sent up from durban; of course it is really necessary to keep them ready as, in this climate, the funeral must be the day following the death, but we have had them covered up now, as i did not like the men to see them when they went up to the store for things. all that last batch of men were frightfully poisoned with enteric, and nothing seemed to stop it; six of them have died, and most of them had symptoms of blood poisoning too. i don't think i told you that the two sisters who went to help on one of the hospital ships till we could get rooms ready for them, came up at the beginning of may. they brought a poor account of the nursing on that particular ship, and said that, when they went away, there was no fully-trained nurse left on board; that a large proportion of the men who had been ill any length of time, had sore backs (some before they reached the ship). it seems sad that when there are so many fully-trained nurses in england longing to come out, these poor fellows should not be getting the best nursing they might have, even right down at the base. on the st of may we heard that mafeking was really relieved, and on the th of may we were officially "opened." general wolfe murray was to have performed the ceremony, but he could not come, as general buller had sent for him, so the bishop of natal and colonel morris did it between them. there were special trains from maritzburg and durban; a good many people to lunch, and such a crowd in the afternoon--no one seems to know how many, but i think we gave tea to about five hundred. fortunately, sister ---- was on duty again, so i was not fixed up in her ward, but she was still needing help with her bad cases. i made the teabags in the middle of the night while i took my turn at sitting by poor captain ----, and several people who live near here were very kind in helping me arrange flowers on the day, and they cut up cake for me. we had a lot of coolie waiters up from durban, and our house-boys and some whom mrs. t. (a most kindly neighbour) sent to help, were washing up all the afternoon. i can't say i enjoyed the day, as we had several patients very ill, and two poor fellows died that day, but we managed to keep their ward (and one of the officers' wards) closed to visitors, so they were not disturbed, and everything went smoothly and well. when the visitors were leaving, i asked the major if the orderlies might come and finish up the cakes, &c., as there was some good tea in the urns still, and they had all been working very well, so he told the sergeant-major they might. i was rather amused at one thing: i took a big tin and gave it to the sergeant-major, asking him to save a few cakes for the night orderlies, but he pointed out to me they were all present; the news of a tea and some good "skoff" had brought them all down from their tents, and they soon made short work of the remains. i went into durban one day to do some necessary shopping, and on the train met colonel galway, the p.m.o., going down to inspect the hospital ships. he was very nice to me, and told me that if i liked to engage any more sisters out here i might do so, and he would take them on; so i am engaging a lady as a kind of probationer and housekeeper. her husband is at the front, and she wants to help, and i think she will be able to relieve me a good deal by looking after the house-boys, putting out linen, &c. our sisters are working awfully well, but some of them don't get on well with the orderlies--a great mistake: they don't seem able to hide the fact that they think the orderlies very useless and incapable, and consequently the orderlies don't do their best in working with them; it is a great pity, as the men are quite willing and anxious to learn, and are very patient in having to do many jobs that must be very trying to them. at last i have got a nice white woman to look after the kaffir washing ladies, and she will do the starching, &c., for the staff. two of the kaffirs were washing all day with babies tied on their backs--such jolly fat and shiny little black-a-moors. i gave them an empty packing-case with some sawdust in it and a mat, and both the babies and mothers were delighted. i actually had a ride the other day; mrs. d. kindly lent me a horse, and i rode with the major over to a most interesting trappist monastery. the trappist fathers cultivate a lot of land, and teach the native boys various trades. they are going to supply us with eggs, vegetables, &c., and the major arranged with them that they should visit our roman catholic patients, and, if any of them die, they will bury them in their churchyard. we shall have to have a horse for funeral purposes, and we have been offered a rather nice-looking black animal, so i hope that, to my varied duties, will be added that of keeping the funeral horse exercised! i don't care much for walking about here, there is so much long grass, and you get covered with ticks (to say nothing of one's natural fear of snakes), so an occasional hour or two on horseback will be refreshing, though up to now i have hardly left the camp except to go to church at pinetown once on sundays. i had a letter the other day from the secretary of the durban ladies' club to say they had made us all honorary members--a very kind and friendly attention on their part. it is a nice club, but whether we shall ever have time to make use of it remains to be proved. there are many strange animals about here: a huge owl is getting quite tame, and comes to be fed by the night sister. the men are trying to shoot a wild cat, but can't get up near to it. after hearing them talking about it, i was rather frightened the other night (sleeping with my door and window open), when something jumped from the window on to my bed; i felt it creeping towards me, and was just going to dive under the bedclothes when it began to purr, and i found it was the camp kitten! xxxi pinetown, natal, _june _. it is rather difficult to know what to write about that will interest you. there is always plenty of work, but it is not of an exciting nature--just steady plodding on, with difficulties always cropping up and having to be waded through. if one had time to sit and talk to the patients one could hear many exciting tales, but most of my time is spent with those who are too ill for much conversation. i think i told you of the arrival of the officers and men from modder spruit. opening the large ward for these officers caused some difficulty, as it is such a long way from the kitchen, but we soon got up from durban some hot tins, covers, &c., and the feeding is going better now. major ---- had been very ill with ptomaine poisoning before he arrived here. he has been a difficult case to feed in this climate, and has been very slow in getting up any strength; but he is well on the mend now. then there was a bright-faced _boy_ with acute rheumatism, who said he had not been in bed for six months, and it was "just heavenly." lieutenant ---- (a bishop's son) is ft. in., and we have to wrap up his feet on a chair beyond the end of his bed. he has enteric, but not so very badly; he called me to him the other day, and told me that he had had the most bitter disappointment of his life--the doctor had ordered him an egg, and he waited patiently till tea-time, expecting a nice boiled egg, but he never knew the orderly would bring him a beaten-up egg, and he had nearly drunk it before he recognised it! then there is second-lieutenant ----, who looks about sixteen, and who only joined his regiment nine months ago, but he has seen a lot of fighting, and was at spion kop, pieter's hill, and other battles. some of his men are here, and they think a great deal of him; they say at spion kop all his seniors were either killed or wounded, but he led the men on as calmly and well as possible; i believe he got a "mention" for it. his captain wrote to me so nicely asking after him, and said, "he is a good boy, and a when the bullets are flying." he had been wounded badly, and now has enteric, but only slightly. the other officers all call him "the boy." i hope we shall be able to send him home to his people soon, as i think he has done his share. some of these officers are beginning to get about now, and they _will_ go to visit the officers in the small ward and persuade them to give them tea there, and then return and get their own tea as well. they say they are "making up for past hardships"! amongst that same batch of men there were two or three rather smart r.a.m.c. men, and we don't think they are going to be fit for duty at the front again this campaign: they will be quite contented to stay here, and work as soon as they are well enough. we have just got the electric light into working order; and, though it is rather erratic, and often goes out, on the whole it is a great comfort. there has been a case of bubonic plague in durban, but they don't seem to think it is likely to spread. twenty more orderlies have arrived, st. john's ambulance men, and the buildings were all complete by the end of may. i have had a few rides on the funeral horse, and, as it is very tame in harness, i was astonished to find it was quite gay and hard to hold; but we have found out that it was once a racehorse, and of course it has never had a side-saddle on before. our nice compounder has been awfully ill with appendicitis and dysentery. we have had to write each mail to his people, but now i am glad to say he is doing well. several of the orderlies are down with enteric, including our mess-room waiter; so "cup-of-tea" has to wait on our mess of eighteen, and needs a good deal of looking after. i expect they will give me another orderly soon, but so many are ill, and the wards are heavy, and need a good many men for night duty. every few nights the orderlies have to do a spell on night (as well as their ordinary day) duty, so they are rather inclined to grumble, and it is difficult for them to keep awake; but i don't think any of them do longer hours than i do, as i prowl about a good deal in the night when the cases first come down and are bad; so they don't grumble too loud. the sisters seemed to be getting rather fagged out, so i have begun to give them in turn a monthly day off, and i look after their wards. i find it is rather useful, as i get a good opportunity of seeing how they have managed, and also of learning how much the orderlies are good for; it is quite touching how good they are to me: they want to show me they can be trusted, and they do everything they possibly can to save me trouble on these "days off." from the sergeant-major downwards they have always been very nice to me, and i am sure i do very little for them (except when they are ill and need fussing over) beyond scolding them for misdeeds for which the sisters report them. i wonder whether they guess that, all the time, i feel that the sisters are expecting too much of them! i was amused when a new sergeant arrived with twenty men the other day; of course, at first they did not know any of us, and when i met them and said "good morning," they simply gaped. the next day i had a fatigue party sent up to tidy the china and linen store; of course our old batch of men saluted when i went to show them what i wanted done; and i expect the new men received a few words from them on their slack manners afterwards, for since then there has been a very stiff draw up and salute whenever they come for orders or with a message. i hear the army sisters are not saluted as a rule. i think i told you how much we suffered from fleas at first; now they are quite banished. we have twenty coolies, and a good orderly in charge of them, and they do all the sanitary work, and sweep and scrub and generally keep the place tidy (they also have to dig the graves), and since we have got rid of all the packing-cases, and everything is trim and tidy, the fleas have disappeared. so far we have had very few wounded in--nearly all enteric or dysentery, with some cases of camp fever, rheumatism, &c.; the medical officers are disappointed at so little surgical work, but i don't think i mind, as we can feel we are actually saving the lives of some of these men by sheer hard nursing, and that is good enough for me; sometimes a man sees that i am worrying about a patient who does not seem to be improving, or who is going downhill, and he will come up and say "never mind, sister, he would have been dead long ago if he had been left in that field hospital any longer; you have given the chap a chance." it is grand to see the first batch of men, who came to us so desperately ill, so haggard, starved, dirty, and miserable, getting about now in their blue suits, looking so clean and bright, though still very thin. some of them are beginning to need to be amused, and the knitting wool and materials for worsted work that i brought out are coming in very useful; in fact, they will soon be finished, but the durban ladies have kindly promised to send me more. several of the men were making worsted belts in one ward the other day, and a big scotchman looked in and asked them to go for a walk, but they refused, saying they were busy, and the scotchman was heard to mutter "they've all turned blooming milliners!" lieutenant ---- (the giant) is getting on very well, and he was always saying i must stay and amuse him, or else give him some toys, so i have started him with some worsted work, and he is more contented, and as fussy about my providing him with the right shades of wool as any old lady. the lieutenant in the next bed has learnt to knit, and major ----, the ptomaine poisoning case, looks surprised at their babyishness. the other day sister b. was going to have a day off, and these boys, overhearing her instructions about themselves, made up some poetry on the subject (which i enclose), and sister won't hear the last of it for some time. we have a service in the wards every other sunday, and the hymn-books i brought out are most useful. _june ._--the last few days have been very busy and very sad. on the th we had a trainload of patients--two officers and seventy-three men--several of the men very bad. i was up most of the first night helping with the bad cases, but one poor fellow died the next day (he was never conscious after he got here); that day also, sister ---- knocked up with slight fever, so i had to take over her ward, and there were several bad cases in it. the orderlies are knocking up with enteric--six of them warded; and i have hardly liked to leave them at night, as several of them are inclined to be delirious and try to get out of bed. l. was the worst, but he did not seem in any special danger till last wednesday: on that day i was orderly sister for the afternoon, and on my first round i talked to them all, and he seemed much as usual, but on my second round i found him distinctly worse, and with a failing pulse. i called his doctor, and we tried everything possible, but he soon became unconscious, and died at . p.m. all the orderlies are dreadfully cut up; several of them come from the same place in yorks. he was such a fine, strong young fellow, and it seems only the other day that he was acting as groom, and put me up on the black pony, and was so pleased i could manage him. he was a butcher by trade, rough in his ways, but so good-natured; i must write to his poor mother. he had a military funeral, and we let every orderly go who could be spared. the clergyman asked me if the men would like to have a hymn in church, so we sang "brief life is here our portion." several people sent wreaths, and the men are going to make a wooden cross. this was the first death amongst our staff. having so many orderlies ill, and the place pretty full, we have been very busy, and many of the men have had to do eighteen-hour shifts every two or three days: that is to say, their usual twelve-hour day and half the night. so they are having a heavy time of it. enclosure:-- sister's "day off" there once was a sister called baker, of beds she's an excellent maker, she knows temperatures too, and between "me and you" is of medicines an excellent shaker. she shows each man's vice--how to treat it, and warns sister h. how to meet it: "no. you can trust but show t-- a crust, well, it's a thousand to one he'll eat it." she dilates on the treatment we need, all our habits, our drinks, our feed; "i repeat, mr. t-- doesn't realise all, but he cannot be trusted for greed." "mr. n--, however, is wise, at the sight of eggs hard boiled he sighs, d-- eschew them i must and that beautiful crust, for on me sister baker relies." you may ask how we know what was said the culprit there lying in bed, overheard in the dark, the whispered remark, and tears of hot anger he shed. the moral is not far to seek: a crust perforates you when weak, while eavesdropping at night is really not right for it's apt to raise anger and pique. (_with apologies to the authors._) xxxii pinetown, natal, _july _. since my last letter we have had a good many changes of patients, some being sent back to the front, and others going home by various hospital ships. it is so nice to see some who were carried in desperately ill, able to march down to the train so cheery and bright, and tremendously grateful. we sent thirty home by the h.s. _dunera_ last month, and were just hoping to have time to breathe, and to get the sheets and blankets washed, when we had a wire to tell us to expect seventy-five more; so we had a scramble to get the beds and bedding ready for them, and they nearly filled us up; but they were not quite such a _bad_ lot as our previous batches had been, and there were a good many wounded by way of a change. we were still short-handed, so had to do a good deal of sorting of patients; turning some wards into convalescent wards, that needed only occasional visits from a sister, and no night orderlies--a sergeant patient being made responsible for good order in the ward. several of the orderlies are still ill: the mess-room man has had a relapse, and will not be fit for work for some time; the second compounder has also been very bad with typhoid--delirious for more than a week--but i think he will do all right now; it has been awkward, as the first compounder can only just crawl about after his spell of illness. we have had one man awfully bad with double pneumonia after a stiff turn of typhoid. then he got a bad abscess in the jaw, and had to have it operated on; for some days his temperature hovered between ° and °, but now he is doing well, and will soon be sent home. we have been inspected by colonel clery, who, unfortunately, came on the day on which we had those seventy-five men in, and before we had got them all washed or their kit put away; but he was very pleasant to me, and said he was pleased with the wards and the looks of the patients, bedding, &c. we have also had several other distinguished visitors--sir john furley, sir william stokes, and major baptie of the r.a.m.c., who won his v.c. at colenso. we have all been very sorry to hear of the death of colonel forrester, who had been in charge of the princess christian hospital train, and had been here several times bringing us patients. the four months for which this hospital was given, equipped, and maintained by private generosity, are now nearly over, and in a few days we shall have become a government hospital. we shall then receive our pay and various allowances from the government; and we are now arranging to separate the mess of the sisters from that of the medical officers. i expect it will be difficult to keep our stores separately, but we shall wish to live more economically than they do. for the present we have decided to share the same cook, an indian who has been acting as our dhobie for the last few weeks, and who, we hear, is a good cook; his wife will continue to act as our dhobie; she is such a pretty little thing, with rings in her nose and bangles on her ankles and arms. i quite expected to be superseded by an army sister proper when the hospital was handed over, but the p.m.o. has asked me to "carry on" (which does not mean the same in the army as it does in cockney land!) the other day poor miss h. arrived. she had started from england as soon as she heard her brother was ill here, meaning to nurse him, and i think i told you he died here (our first death amongst the officers). it was awfully sad for her. i was frightfully busy the day she came, but felt i must walk over to the cemetery with her. she is a trained nurse, and we should have been very glad of her help if she could only have arrived in time, as her brother was delirious for so long, and we had to take turns at sitting up with him for some time; but everything that could possibly be done for him was done. they do seem to muddle things a bit; in the last few weeks we have had _seven_ new sisters sent to us; we would have given anything for a few of them a couple of months ago, but now there is much less fever, and many of the beds are filled with convalescents. we had no rooms for so many sisters, so had to put up tents for them. one day we sent off a batch of over fifty men for home, emptied several wards (putting the remaining cases into other wards), and had a general clean up; the same day we had a wire to tell us to expect seventy-two men the next evening, so we had a scramble to get the linen dry and everything ready for them. they proved to be all convalescents, and they came down thinking they were going straight on board ship for home, and of course were rather disgusted at being stopped here. the next day, having got them all settled in, and their kit stowed away, we had a wire asking us to send sixty men down to durban the next morning for home! so, again, there was a great bustle and inspection, and the lucky sixty having been selected had to retrieve their kit from the store and be fitted up with comforts for the voyage. we feel sure that it was all a mistake their coming here at all, and that they ought to have gone straight on board ship. of course it gave us an awful lot of work, and did not do them any good. we must try to see the remaining twelve get off with the next batch. the other day fifteen new orderlies came, men of the imperial bearer company (chiefly recruited from refugees and other colonials). some of them are quite old and bearded, and there was much puffing over their march up from the station. it is so funny to have to hurry these venerable gents round the wards when they look at me solemnly through their specs, and the tommies are rather inclined to humbug them. some of our original st. john's men will have to leave soon, as their time is up, and we are letting all those go who are not very keen on the work, but, unfortunately, some of the keen ones want to go too. i am sorry to lose them, and rather blame the sisters for it. the orderlies have been awfully nice to me; two of the best have been promoted to be sergeants. one, who has been chiefly in the officers' ward (he is a railway guard at home), has been splendidly patient with them all; and the other is the man who has been in charge of the sanitary work and managed the coolies. i have been having a little riding lately while the extra sisters have been here, and all the sisters in turn are having a few days' leave. one day some people asked us to go for a picnic (riding), so we collected all the screws we could, and, making a party of twelve, we rode to a very pretty waterfall about nine miles from here, and they had arranged for tea at a quaint old farmhouse near by. riding back by moonlight my (funeral) horse was so keen that i could hardly hold him, so i was riding ahead with one of the men, when, hearing a shout, we hurried back and found the senior civil surgeon had had a tumble. he was not much of a horseman, and they had put him on the very quietest nag, but it had stumbled, and he came off. he managed to ride home at a walk, though he was unconscious for a few minutes at first. he was a good deal shaken, and had to keep quiet for some days. another day we went to the trappist abbey; when we arrived, they kept us waiting some time in a room, and then a meal suddenly appeared--poached eggs, delicious brown bread, honey, fruit, tea, and tamarind wine. we were surprised, as it was early in the afternoon, but we felt obliged to accept it, and it was all very good, though i shied at the tamarind wine. afterwards they showed us round the place. it is really wonderful what these trappists do for the natives, with their schools, shops for bootmaking, saddlery, tanning, ironmongery, printing, photography, &c.; but whether it does the native any real and lasting good to teach him all these things is quite another matter. everything seems to be running more smoothly in the hospital now, and even if the place were full of bad cases (as it was at the first), now that the orderlies are getting to know their duties, we feel that we could tackle the work without the hopeless sensation of being unable to do half enough for everybody. we are very lucky in our major: he is very keen to have everything well done, and one can always go to consult him in any difficulty. xxxiii pinetown, natal, _august _. we are now a full-blown military hospital, instead of being partly civil and partly military. everybody had talked so much about the coming of "red tape" that i had been a little nervous about the change; but, except just in the transition stage, everything has gone very smoothly, and when everybody gets used to the military ways i think it will be all right. personally, i shall have much less worry and responsibility, for we now have a lieutenant-quartermaster of the r.a.m.c., and i shall not have to try to look after the linen and other stores. moreover, a batch of indians has arrived and gone into camp, with a good headman, and they will do all the washing over which i have had so many struggles with careless kaffir women. i had to attend a big function down in durban, when the residents presented the gentleman who gave this hospital with an illuminated address. there were many speeches, and much "butter" for all the staff. i was presented with a large photograph of the address. we have had a good many changes in the staff, and among the civil surgeons who have gone home is the only one of us who understood the electric light plant, with which, in consequence, we have had difficulties. i hope we shall soon find an orderly who understands it, as, when the light fails and we have to grope about with candles, the men cannot read, and find the long evenings very dull. i hear many interesting tales when i go about trying to amuse the men on these occasions; the other day i was called to enjoy a joke--some of them had asked an irishman whether he knew what "strategy" meant? and he said "yes, it means like this, sure, when you've fired your last cartridge, don't let the enemy know, but jest kape on firing all the same!" i don't know whether it was original, but he brought it out as though it was. i have had a few days of slight fever since i wrote last, and i took a couple of days off, and spent them at umkomaas with some friends, who have a nice cottage down there. it is the most perfect little seaside place i have ever struck; such jolly woods all round the cottage, with semi-tropical growth, and lots of monkeys in the trees; glorious rocks, and _such_ a blue sea. i had a delightful rest, and came back much better, but of course found various muddles to face, and they always make one wish one had never gone! the worst thing i had to straighten out was a complaint from a medical officer about a sister; they had been rubbing each other the wrong way for some time, and of course i thought if i had not gone away i might have kept the peace; however, as the complaint was a definite one (though in no way serious), and was also _just_, i had to move her to a less important ward. this very much hurt her feelings, and i was sorry, as, though not a good manager, she is very good to the patients. now she works for a different doctor, and there is peace in the camp. all the civil surgeons and sisters growl at the new military rules and regulations, but i think they are rather inclined to make mountains out of mole-hills--they can really get all they want if they set about it in the proper way, but they don't take the trouble to find out what _is_ the proper way. perhaps i have rather spoilt the sisters by letting them have things that were urgently ordered from my stores at any time, but now that the place is not so crowded up with bad cases they must learn to order in the proper way and at the proper time. in one respect i was afraid that our system would be changed, but the major has very kindly arranged it as i wished; i saw, when at the cape (and heard of it in other hospitals), that when a sick convoy arrived there was much delay before the men were classified and put to bed--sometimes not until several hours after their arrival. one cause of the delay was that each man, if he could crawl, had to go up to the store to draw his kit and sign for it himself; the poor chaps used to look so frightfully ill and tired with this weary waiting about, before they could get food or a wash, after (perhaps) some days in a train. here we have managed quite differently; as soon as we received the wire saying that patients were coming (and the number), we had everything issued for that number; the beds were all made up, and before they arrived i used to go round and see that the crockery for each man was on his locker, a clean shirt, towel, soap and flannel, &c., all ready, so that the men could be carried straight to their beds as soon as they arrived, and have a good basin of bovril without any delay; then those who were well enough to go up to the store to give in their kit and to receive their hospital suit did so; and the orderlies took up the kit of those who were too ill (of course they did not want hospital suits). now it is necessary for all, who are able, to sign for their equipment (sheets, blankets, &c.); but the major lets us have some beds fully equipped in each ward before the men arrive, and the orderlies sign for those fittings until the men arrive, and then they countersign the book, so that the bad cases can still be carried straight to their beds. our new mess arrangements are working well; it is much more comfortable having a cook with a kitchen separate from that from which all the food for patients, orderlies, and others is served. we had to buy a new stove, but as the expense was shared between the medical officers and sisters, it did not come to very much. our madrassee cook is serving us very well. i thought it would be difficult to keep our stores separate, but he seems to manage well and economically, and he is a good cook and serves the things up very nicely. we share the expense of his wages with the doctors, but have separate boys for our mess waiters and for our rooms. i have kept john on for the sisters' rooms: he is very slow, but a good old thing, and very clean. it is the custom for these boys to go home for a day or two when their wages are paid, but you always keep some of what is due to them in hand (or they don't come back); but when the hospital was handed over to the government, the boys were all paid up to date, so of course they all cleared, but john promised to come back in two days, and i thought he would; but it was six days later when i found him slinking about his work and looking like a big dog that expected a whipping. i said, "oh, john, you bad boy, sisters not have you back any more," and then he said his wife was "plenty sick," but i told him i thought kaffir beer was plenty good, at which he grinned, and i had to forgive him! william, our good scamp of a mess-room boy, never returned, so i had to go into durban to the toct (or tax) master at the police station, who generally looks after all the natives and gives them their passes, &c. i chose a boy who was recommended, but he never turned up, so i was thinking i must go again and lead one out from durban with me, when the dearest little kaffir turned up, with a note from the toct master, saying he was a very good boy, and his name was "imdenbe, son of cholem, chief of imsugelum, umtenta," so i was rather relieved when the boy said his name was "dick"! i thought he was much too small to reach to put the things on the table, but he is very quick and nimble and clean, and both the cook and john are very fond of him; so we manage all right, and he looks perfectly sweet in his white suits with red braid--they all wear things like bathing-dresses, with short sleeves, and go about barefoot. the worst of the enteric season seems to be over now, and we are very slack, and we hear it is the same at all the hospitals up this side. the days are still very hot, but the nights are quite cold. i expect you hear more about this hospital commission than we do, but the r.a.m.c. men are very sick about it, as they have worked so tremendously hard all through the war. i think every one agrees that the tommies have never been so well looked after in any war before, but no doubt at the front they have suffered badly, more especially at bloemfontein, where, suddenly, the army was attacked by a perfect scourge of enteric (i believe there were about cases there); but people must remember they were miles from their base, with only a single line of rail, and for the last miles almost every bridge destroyed, so that all traffic had to be carried on with the utmost caution over temporary bridges, only a few trucks crossing at a time; also it was an unusually dry season, so that engines often had to drop their heavy trains, run on to get water, and then return for them. the transvaal could practically supply nothing to feed the troops, as the boers had planted no crops. to get sufficient rations up daily for the men and horses was just about all the one rail could do, and when it was necessary to leave the railway line, the troops often had to wait weeks to scrape together rations to carry with them. i believe the r.a.m.c. were well prepared for the probable number of wounded, but when unexpected sickness knocked the men over by the thousand, it is scarcely surprising that it was impossible to get up tents and all medical necessaries and comforts quickly enough. i believe the sick and wounded are quite comfortable now in bloemfontein; but no doubt there was suffering there, and the commission will find out whether it might have been prevented. there can have been little excuse for the bad management that is complained of at the base, and if that is proved, no doubt some one will get blamed for it. i know the single-line railway on this side, that passes close to us, has been very hard worked night and day; at one time eight trains went up each day with water-tanks only, besides almost incessant trainloads of men, horses, mules, stores, &c.; the only wonder is that there have been so few accidents. all the sisters have now had some leave, and as we have extra sisters here and very few bad cases, i am going to take a run up-country with a lady from here, and hope to tell you about that next time i write. xxxiv pinetown, natal, _august _. i must first of all tell you of my interesting few days up-country. i left here on the evening of the th of last month with mrs. d. and her baby and a small kaffir nursemaid; she was going to stay with friends who have a hotel and store at colenso, and i had engaged a bed at this hotel, and took my saddle with me hoping to secure a horse there, and be able to explore the country around. two of our medical officers were going for a run up-country the same day, but as the train ran in two sections, i only saw them on the platform at maritzburg late that evening. at the same time i saw another officer in khaki looking at me, and then recognised in him a well-known london surgeon who is chief of another hospital out here--of course i was more used to seeing him in frockcoat and top-hat. he had his wife on the train, and as they also were going to colenso, i was very glad to be able to be with them there. the train rocked about so much (first crawling up a hill, and then tearing down the other side) that it was difficult to sleep, but the baby slept like an angel with the little kaffir girl, safely deposited on the floor. at . the next morning we arrived at colenso. it was very cold and very dark, but mr. edwards (the hotel proprietor) met us, and with him we stumbled across the veldt to his hotel, which is just a one-storey shanty, as their house had been knocked to pieces by the boers. unfortunately he could not possibly take in my friends, so they had to stay at the station. i was very glad to be able to tumble into a clean bed and have a good sleep, and by breakfast-time i was quite fresh again. then i was annoyed to find that i could not get a horse, as they were all engaged, and i had hoped to be able to ride to ladysmith and to spion kop; however, i got on all right in the end. that morning we climbed hlangwane hill, and saw some really wonderful boer trenches; you absolutely can see no sign of them in broad daylight till you nearly walk into them. then we saw the place where colonel long lost his guns (the dead cavalry horses are still lying there); and where poor young lieutenant roberts was mortally wounded in trying to save them; and where major baptie, r.a.m.c., won his v.c.--i think by carrying lieutenant roberts into a donga and staying with him, and other wounded, all through that day of heavy firing, trying to keep them comfortable with some morphia he had with him. we picked up as many pieces of shells and shrapnel as we could carry, and walked back along the banks of the tugela. i heard that a luggage train would be passing at . p.m., so i thought i would go into ladysmith by that, and see whether there was any chance of getting out to spion kop from there. there are very few passenger trains now (except just the mails), so we are allowed to travel in any train that happens to stop, but of course they don't undertake to keep to any particular time. directly after lunch i strolled down to the station--no station-master or any official there, but i met a gentleman who told me that he had walked all the way out from ladysmith, and was expecting to have to wait for the mail train to take him back, so he was very glad when i told him i knew the next goods train was going to stop there; he said his wife was in the waiting-room, so we walked along to find her, and soon i discovered she was mrs. ----, secretary of the women's patriotic league in durban, whom i had not actually met before, but with whom i had had much pleasant correspondence, as they had been very kind in helping us. so we trained in to ladysmith together, and on the way they pointed out to me the remains of the great dam which the boers made to try to flood ladysmith out, also the neutral camp of intombi; there is no hospital there now, only the cemetery, sadly full of graves. they told me they were staying at the "royal," and that people from there frequently drove out to spion kop; so i walked up with them and interviewed the manageress, who told me that a party of ladies had engaged a waggonette to drive out there next morning, and she thought i could easily secure a seat. eventually i met these ladies, and found they were durban people who had been over here to help at a concert for our men, so they were very kind and said i had better stay the night (as they had to start early in the morning) and dine with them. i went out and wired to colenso not to expect me back, bought a few necessaries, and then took a look round the town. the hotel i was staying in had had a big shell right through, which had killed a man who was sitting in the hall, and the town hall had had a great piece knocked off the tower by one of long tom's shells. then i climbed up to the convent, which was used at first as officers' quarters, but had been tremendously knocked about by shells. the kind old sisters were very busy with workmen, patching up holes in the walls, &c. then i walked out to the cemetery, rather a long walk, and it was getting dusk, so i could not stay long; there were rows and rows of siege graves, and amongst many interesting names i saw those of the earl of ava and poor george stevens of the _daily mail_. it was quite dark when i got back to the hotel, and i was glad of dinner, and not sorry to go early to bed. it is eighteen miles out to spion kop, and they won't send a carriage there for less than £ , but for that sum you have four horses, and six people can go in the carriage; i had told the manageress that i would gladly pay £ for a seat, but in the end i was not allowed to pay anything, as there were only four besides myself, and they had already arranged to pay the £ , and would not let me share. we started at a.m. with a black driver, and a small white boy to act as guide. many of the horses that went through the siege have not yet recovered; one of ours was taken worse on the way, and we had to wait while the driver crushed up a nut between two stones and thrust it down the horse's throat, then it struggled on till we reached the kraal at the foot of the hill at a.m., and outspanned. on the way we passed the place where colonel dick-cunyngham was killed. we had a bite of lunch, and then started with our small guide up the thaba inyama, one peak of which is "spion kop." we had with us a january number of the _natal mercury_ giving a full account of _the_ day, so we were able to trace the positions, and i had heard the men talk so much about it i felt i knew my way quite well. of course we went up from the ladysmith side (where the boers were), but from the top we could look over to potgieter's drift and spearman's camp, and marvel how our poor chaps ever got up in the dark, with the boers in such good cover above them; and _then_ to be ordered back must have been frightfully disappointing. we saw many english and boer graves, and i took a good many photos, including one of the cross on the spot where general woodgate fell. we picked up heaps of cartridges (full and empty ones), emergency ration tins, soldiers' uniform buttons, &c.; it was too hard climbing to burden ourselves with any shells, but i bought a few from kaffirs who had gathered near our carriage. i am collecting a very varied stock of ammunition, including one soft-nosed cartridge. they were burning the grass down all round the base of the hill, and every now and then a cartridge went off; we hoped the fire would not come across any stray shells while we were there. we had a splendid view of the drakensberg range. returning to our carriage we had lunch, with an admiring crowd of rather naked kaffirs around (who seemed much to appreciate our remains), and we started for the return drive about p.m. the sick horse was worse on the way back, and had to have several doses administered. as we were nearing ladysmith, i found we were passing close to tin town hospital; so, thinking it was a pity to miss seeing the place, i left the carriage and walked across a drift on the klip river. first i passed some officers on their ponies playing at "heads and posts"; then i came to the horses' sick camp, and met a nice old veterinary sergeant (who, i found, was a colonial who came from kimberley, and of course knew people whom i had met there); he told me he had charge of sick horses, but many of them were "convalescent," and if he had known i wanted a horse he would gladly have lent me one; he said if i would stay another day or two i could send down for my saddle and he would lend me a horse and a mounted orderly so that i could ride to bulwana, waggon hill, cæsar's camp, and other places which i should much have liked to visit, but i could not spare the time. then he took me along to the sisters' huts. i found the lady superintendent was out, but some kindly kilburn sisters gave me some tea and took me round the hospital; not many cases in just now, but a few very bad enterics. the sisters told me that as the red cross ambulance (drawn by eight mules) was going into ladysmith, i could drive back in it. i was just going to climb inside when a gentleman in khaki came and asked me if i would not rather ride on the top with him, so i gladly climbed up, and found he was a doctor (one of the big civilian doctors); he had heard who i was, and amused me by saying he wished i had called at their mess (fancy shy _me_ calling at an unknown officers' mess!) instead of going to tea with "those estimable females," as they would have shown me more of the place, and they have a good collection of curios that would have interested me (he was looking at the things i had picked up). it was a very jolly drive, and he insisted on driving me right up to my hotel. i must really tell you about the rest of my travels in my next letter. i was away only five days, but you will see that i squeezed a good deal into those days. xxxv pinetown, natal, _september _. i will just finish telling you of my travels while they are fresh in my memory, and then this letter can wait till there is enough material to fill it up. i was very sorry to hear from my friend on the ambulance of the death of sir william stokes (physician); he was ill only four days, and it seems only the other day he came round this hospital and was so cheery and bright, and i know he was meaning to say a good deal to the hospital commission in favour of the hospitals out here, and of the work they have done. i just had dinner with my friends at the royal, and then the 'bus took me to the station with my heavy bag of shells, &c., in time for the . p.m. train back to colenso. i was awfully tired, but the mosquitoes were bad, and did not let me have much sleep. the next day i was invited to go with a picnic party to the tugela falls. a large ox waggon was loaded up with children, provisions, &c., and i went with some more people in an army service corps scotch cart, with no springs, drawn by four mules, who frequently ran away, and who seemed to have a rooted objection to keeping to the road (or rather track); so the journey was rather perilous and distinctly painful. we passed fort wylie, and saw where all the fighting took place on pieter's hill, and we saw the rough bridge that the boers had made over the tugela by simply pulling up our rails with the sleepers attached and throwing them into the river. we had lunch close by the falls--even after this very dry season it is quite a big fall--and after lunch we climbed the hills around, including hart's hill. on the top of this hill is a big memorial stone to colonel thackery, several more officers, and _sixty-seven_ men of the th inniskillings, who fell up there, and we also saw their grave (fenced in) at the foot of the hill. by the time that we got down to the line again it was blowing a gale, and _such_ dust, so some of us sheltered in a platelayer's cottage. he had a fine collection of shells and other relics; his cottage had been used by the boers as a telegraph station, and we found he had been in the smash-up of the armoured train, when winston churchill was taken prisoner. as mrs. d. had her baby with her, and it was now a really bad dust-storm, this man kindly stopped a goods train with his red flag, and we returned comfortably to colenso in the guard's van. i should much like to have had longer stay both at colenso and ladysmith, there was so much of interest both in the places and in the people one met; but i wanted to visit a few places on the way down, so i left colenso the next morning at . . my first stop was at chieveley, where there had been a big hospital, but all that remains now is a little closed-in graveyard, with nearly two hundred graves; many died from wounds, but many more from enteric. they had a clever way of marking the graves, each man's name, regiment, &c., being written on a slip of paper and enclosed in a medicine bottle and securely stuck into the mound. i saw poor lieutenant roberts' grave (it has a plain stone with an inscription, but i hear a cross is being sent out); they had brought him from colenso on the ambulance train the evening of the day he was wounded. the station-master told me he had helped to lift him out of the train, and he seemed sensible and comfortable then, but he died the same night. i saw a very fine redoubt at chieveley made by the royal engineers, but it was never used. i took the next train on to mooi river. before we reached frere station we passed the place of the armoured train disaster, and the graves of the royal dublin fusiliers who fell there. wherever you go there seem to be graves dotted about, most of them enclosed with barbed wire, and some with a cross set up, or the man's initials marked out in empty cartridge-cases. there is a large hospital at estcourt, but i had only time for a hasty lunch at the station there, as i wanted to have an hour or two at mooi river, to see the hospital, where i knew one of the doctors, and where it seemed probable that we should be sent when we first arrived; on the whole, i am glad we were _not_ stationed there, though they have had more interesting surgical work than we have. unfortunately my friend was away, but the superintendent kindly showed me round, and i had tea in the sisters' mess. they have beds, nearly all under canvas. it was blowing hard, and while i was there it began to rain, and it was snowing on the drakensberg, and very cold, so every one looked rather miserable. it is a desolate place on the bare veldt. i left again on a goods train at . , and rattled down to maritzburg by p.m., where i meant to stay the night. miss ---- kindly met me at the station, and we drove down to her house in a riksha; she has been taking in convalescent nurses, and feeding them and giving them a rest. she has had much anxiety about her brothers, one of whom was commandeered and had to fight for the boers, together with his son (a boy of sixteen). they were with cronje at paardeberg, and are now prisoners at st. helena; another brother was fighting for us, and was taken prisoner by the boers, but released when we took pretoria. miss ---- wanted me to go out to howick to see the falls there, and to have a look at the big convalescent camp, where they have beds; but the train left half-an-hour earlier than she thought, so i missed it, and instead she took me to see the maritzburg hospitals, fort napier, grey's hospital (now civilian again), and the garrison church, the last the most comfortable looking hospital i have seen further up-country than this one, but it was a little strange to see the men in their hospital suits lounging and smoking on the church steps. i met a sister whom i had known in london. she was excited about playing in a cricket match; and as she and all the eleven sisters had been given a week's leave from duty to practise for this cricket match, they are evidently as slack in the way of work as we are. i had some nice greetings from some old patients of ours, now on duty in maritzburg. i left there about p.m., had dinner at inchanga with a _daily news_ correspondent, and got back here about . p.m. some orderlies were at the station and kindly carried up my load of curios, &c. the two medical officers had got back the night before, and though they went as far up as newcastle they had not seen as much as i had, and regretted that they had not had my offer of a convalescent horse at ladysmith! i have seen a good many hospitals, and met a good many sisters, and i have gathered a few hints of little ways in which we might improve this hospital; but, though "i says it as shouldn't," i don't think there is any hospital up this side where the men are more comfortable and happy, and i think the sisters here are better fed and their mess bills are no higher than at any of the hospitals--indeed, lower than most of them. i was glad to find that they had had a peaceful time while i was away, and no difficulties; and as there are actually only eighteen men and ten officers in, we are still very slack; we expect some more any day now, but there is very little sickness just at present. you ask about the men and their letters; it was rather difficult when we were so frightfully busy at first to do all that one would have liked, but we always try to write for the men who are too ill to write for themselves, and i always saw that all the men who wished had writing materials, and they used to help each other. they say at some of the base hospitals stray lady visitors have been such a nuisance in interfering with the nurses, but i could well and safely have employed a few stray ladies in amusing the men, writing their letters for them, &c. the friends of those officers who were dangerously ill were all written to by each mail. now that we are slack, of course, i have much more chance of talking to the men, and they tell me many tales of the fighting, and of the rough time they have had at the front; but you will hear plenty of that from the men who have gone home. i am beginning to have many grateful letters from our patients' friends at home. there has been some delay about our pay lately, and some of the sisters who were lodging here had not received any since they left england, so were not able to pay their mess bills, and i had to pay various mess accounts when i got back from my run up-country, and began to feel rather anxious as to whether i could go on feeding my large party of sisters; but now the pay has turned up, so we have got straight again; and the government give us various allowances--colonial allowance, and for mess, servants, fuel, &c., so we are feeling rather well off. we are much enjoying a big package of papers that the red cross society now send up to us each week; whole weeks of _times_, _daily mail_, _daily graphic_, _daily telegraph_, _standard_, _illustrated london news_, _army and navy_, &c. they are the greatest boon to the whole camp. the men point out to me the "pretty boys" in the illustrated papers when they see any pictures of soldiers, as, by comparison, they all look so thin and rough out here. xxxvi pinetown, natal, _september _. now we are really getting busy again. patients keep arriving, sometimes small parties, sometimes large. early in september we admitted thirteen men who had been prisoners in pretoria for nine months. they were very weak and run down, and so happy to be here; when i took them their first basket of fruit, they simply wolfed it down, as they had seen no fruit since they went up-country. then we had rather a "difficult" batch of officers sent down from mooi river. they have no officers' wards there, so these men had been quartered in a hotel more than a mile from the hospital, where each had his own room and servant, and they seem to have ordered and done just what they liked. up to now we have never had more than three or four officers well enough to sit up to meals at one time, as they have always come to us really ill, and as soon as they were well enough they have either rushed back to the front or have been sent home on the hospital ships; but with these officers from mooi river (none of them very ill), i suddenly found that we had twenty-four sick officers in, and that _sixteen_ of them were well enough to sit up to meals, and that it was not suitable for them to eat in the ward where there were a few men still very ill; so, eventually, a large tent had to be rigged up for them, and as it was a long way from the kitchen there was some difficulty in getting the food to them hot. the medical officer was a civilian, and he did not seem to think he had anything to do with the responsibility about feeding these hungry convalescent officers; in fact, every one seemed rather inclined to say "it isn't my work"--and our st. john's men are not like r.a.m.c. men, who may be accustomed to turning to as mess waiters on occasion; neither was the cook quite ready to serve up a dinner of several courses instead of single "diets" for each patient. i am afraid i had to worry the poor c.o.; but i knew if i did not do so the officers would complain they could not get anything to eat; and, after wrestling through the first night's dinner--(when i found well-meaning orderlies running down with the fish before the soup, and some vegetables after the sweets had been served!)--we laid plans for better management, and for a day or two the major went to the kitchen and saw the food sent down in proper order, and i received it and saw it served in the tent, and four of the officers' servants were told off to wait each night, and the orderlies had only to carry the food down for them. so now that is running all right, and i only just have to look in to see they have all they want. for some time we have been expecting to be inspected by the hospital commission, but at last we heard they were not coming here at all, as there had been "no complaints" about this hospital; so i should have been very vexed if our record had been spoilt at this late stage of the war. our next order was to prepare for a train that was bringing us seven officers and men from pretoria (the biggest trainload we have yet received). having had sisters here over our correct number for some time, and very little for them to do, of course as soon as we got busy we kept having wires to send one sister for duty on the hospital ship _avoca_, or two sisters to the hospital ship _dunera_, and so on, and none of them wanted to go, so it was a little difficult to sort them. in fact, there have been so many orders and counter orders that i should never be surprised if i had a wire telling me to go off on a hospital ship, or if we had orders to pack up the whole hospital and take it up to pretoria. before mr. x. left, he let us buy some remaining groceries at home prices (a great saving for our mess), and after we found a small storeroom to arrange them in, i, rather foolishly, let them use the cases for firewood, which has been very scarce here; so, if we have to move, all the sisters intend to sling bottles of fruit, and tins of jam, sardines, &c., round them, as we really can't leave our stores behind! i hear that the army sisters on the hospital ships are rather horrified that i am still left in charge here, now that it is a military hospital, and that there are plenty of army sisters out in the country; but the p.m.o. has been very nice to me, and i am very glad to "carry on" as long as they want me; the only thing is that i should very much have liked to see a little of the work nearer up to the front, and as it seems probable that this place will become, later on, a sort of convalescent home, the work will not be so interesting. yesterday some officers went down to durban, and came back much excited by rumours that the line and the wire had been cut at standerton, that boer prisoners had been released, that johannesburg was surrounded, and a few more exciting items, but i dare say they are not true; i never pretend to tell you about the war. by degrees we are getting a few r.a.m.c. orderlies and non-commissioned officers, and of course they make the work easier for us; but we are quite proud of some of the st. john's men, who are becoming excellent and most efficient nurses, and they really knew nothing of nursing six months ago. i had a great triumph when the big batch of men ( ) arrived, as everything had been issued for them the day before and signed for by the orderlies, and half-an-hour after they arrived every man was either comfortably in bed or had had a preliminary wash and was ready to sit down to a good meal, and after that he went up to the store to hand in his kit; some of the patients and some of the r.a.m.c. men told me that in many of the military hospitals it would have taken four or five hours to get so many of them settled and fed. there are several very bad cases amongst them, but also a good many convalescents. we have two officers desperately ill, one a major in the r.a.m.c., who, i fear, is not likely to get better, though they are trying everything possible for him, and the other is a lieutenant in the rifle brigade who has been delirious for a long time (enteric) and very ill, but i fancy he will pull round. i have been able to give him special nurses when necessary. also we have a bad case of enteric in the men's ward; i don't think i have ever seen a case where there has been so much hæmorrhage, and yet i think he will pull round, though he is nearly a skeleton, and even i can easily lift him up while his sheet is changed. i have been much pleased at the really tender way the orderlies have nursed this boy, as he has needed a great deal of patience. we are getting quite keen on our gardens now that we have a little more time to breathe, but whenever i plant anything i wonder whether, by any chance, i shall be here to see it grow up. i now have some healthy violets and some ivy-leaf geraniums. some time ago i had two beautiful orpington hens and a cock given to me. they lay splendidly, and the eggs have been very useful, but they showed no sign of wishing to sit, so i got a friend to put some of my eggs under a broody hen, and hope soon to have some young orpingtons. the men have not had time to make me a henhouse yet, so we have to keep a sharp look-out to secure the eggs, and our small dick is very attentive to them. i went into durban the other day to do some shopping for the mess, and saw some friends, and then i went down to the jetty to see some of our orderlies and patients (a nice lot of men of the coldstreams and other regiments, many of them wounded from pretoria), who were going home on the _montrose_. i met a sister whom i knew, and one of our medical officers was seeing the men on board, and one of the embarkation people invited us to go out in the tender to the _montrose_ at the outer anchorage; so we had a nice little sea breeze, and the officers on board gave us tea, and offered to show us our cabins, so we had a good chance to stow away for home! six of our orderlies were going home on duty, and they all came to say good-bye, and we had quite a "send off" from them and the old patients when we left the ship. to-day some people have been giving a picnic at a pretty place called krantz kloof. they invited all we could spare to join them, so i let six sisters go, and four of the medical officers and four convalescent officers also went off with them in an ox waggon at a.m., and they did not get back till p.m. i have been busy all day keeping an eye on the place generally to see that nothing was neglected while so many were away. the night sister and night special both went, so i have now sent them to bed for a few hours, and i have been writing beside lieutenant ---- (of the rifle brigade), but i am sure he is better to-day, and to-night he is inclined to sleep; every now and then i let the orderly sit by him while i take a prowl round to see the other wards are all right; now it is a.m., so i shall call the two sisters and turn in, and i need not hurry up in the morning unless there are any fresh orders to attend to. xxxvii pinetown, natal, _october _. we have had a good deal of rain lately and the country is looking lovely again: you can almost see the things growing in the garden. sometimes it rains for three days without stopping, and south africa without the sun always looks very gloomy, but when the sun comes out again it makes up for the gloominess. it has begun to get very hot rather earlier than usual, and the thermometer showed ° in the shade the other day. last month we took in fifty more men who had been prisoners with the boers; a good many of them were gentlemen troopers of the yeomanry; they were sent here _via_ delagoa bay; one of them brought a parrot, and there were several small birds as well. then the other day we took in eighty men from charlestown, nearly all convalescents, and such a mixed lot of regiments--scotch, irish, australians, new zealanders, and tasmanians, and one little australian bugler, aged fifteen, whom all the men spoil. the poor major of the r.a.m.c., who i told you was so ill, died in the early part of this month; it was very sad, as he knew so well what all the bad symptoms meant as they appeared. i think i told you also of lieutenant ----, who was desperately ill for so long. we had a very anxious time with him, as the delirium went on for so long that we began to fear it would become permanent, but at last he pulled round, and has been such a nice patient. we have very few officers in now. the natal volunteers were expected to return to durban on october nd (they have been a year at the front), but the boers attacked a convoy near dundee, and they were all ordered back. durban was preparing a great welcome for them, and the meat for the big lunch that the mayor was going to give them was actually cooked! they got home about a week later, and we all went down to the station to see them pass, many of our old patients amongst them. i had the bad luck to have a nasty fall out riding early in the month, and am only beginning to crawl about again, with a good deal of pain from a damaged kidney. one of the medical officers was ill, and had asked me to exercise his pony any time i liked to use it (he didn't like the kaffir boy taking it out), so, when the major and another man asked me to go with them to pay a few calls on people who have been very kind to us here, i thought it would be a good chance to exercise the pony. from here down to the station is a good bit of soft sand, and all the ponies were fresh, so we let them scatter along; then i saw there was a train shunting at the level crossing, so i wanted to pull up before we got mixed up on the line (of course no gates here), and just then one of the men lost his hat; my pony got cross at being checked, and bucked a bit, and then suddenly swung round and jumped a fallen tree, and off i went on the wrong side, falling across a branch of the tree. i can't think why i fell, except that i was so sure i could not come off, i never thought about sticking on, and was preparing to give him a licking for being so stupid. i did not feel much damaged at the time, though i thought i should have a big bruise just above my hip, and when they had caught my pony i remounted and we went on again; luckily most of the people were out, but at one place i had to get off, and when it came to remounting i simply could not spring, and had to condescend to mount from a chair, and when i got home i felt really bad and had to go to bed. fortunately there were plenty of sisters to do the work, and things went on all right while i was laid up, and now i can get about enough to do the housekeeping, and hope soon to get round the wards again, but they are very quiet at present. we have rather amusing "tiffs" between the officers' and sisters' mess; just now potatoes are very scarce, as the military people have bought them all up; i found the cook was using mine for the officers, as they had run out, so i told them i had had to pay s. d. for a bag, but i should charge them more by the pound! they thought i had paid too much, and asked the c.o., who was going into durban to bring them out a bag. when he came back, he had to confess that he had had to give s. for a bag, and it never turned up at the station, and he had no receipt, and did not know the name of the shop! we are constantly having to make little exchanges of food, &c., but it is necessary to keep a very sharp eye on our supplies. our nice little imp, dick--otherwise imdenbe, son of cholem, chief of imsugelum, umtenta--got home-sick, and wanted to go home to his mother, so now we have another boy for the mess-room. i dare say dick will come slinking back when he has spent his money. john, the big house-boy, is still here, and is an excellent servant. when we first came, mr. ---- let him take care of his horse (of course paying him extra), but then, when other medical officers also got horses, the major said that one boy must look after them all--as there were difficulties about fodder, &c.--but when mr. ---- told john, he said, "no, sir, me never give up tommy; tommy he clean, he fat, he happy, and john love him; john cry very much if boss give tommy one new boy." but poor john had to give him up; and i believe he _did_ cry. in my room i have the luxury of a big wardrobe with glass doors, and john takes great pride in this piece of furniture; i believe he loves to see himself in the mirror. one day i found he had turned my dresses out to dust inside--i expected him to proceed to tidy the drawers next, but i drew the line there! he keeps our rooms beautifully clean, and is absolutely honest. the other day he knocked at one of the sister's doors when she was having a bath, and when she told him he could not come in, he said "it's only me, old john," and was quite hurt that she would not unlock the door. i think i told you about his going home after payday and stopping too long: the same thing happened again the other day, and when he came slinking round with his broom and pail again (looking as though he expected me to hit him), i said, "oh, john, i just going to toctmaster for another boy," and he said, "no, missus, me never leave the sisters, but my wife very sick, and it rain very much, and--kaffir beer very good at my kraal," so i had to forgive him, as he was honest about it! we have had a good many changes amongst the sisters lately, but at present they seem a happy lot, and they work well; they have been much more contented since they took their few days up-country, as it has made them realise that in most ways they are better off here. as the summer comes on, the creeping and crawling beasts are getting very objectionable; amongst others that come into my room are grasshoppers, locusts, flying beetles (huge brutes), and mosquitoes. when they get very numerous, i have to turn my light off and wait till i hear them all make for the electric light outside. there are six cats about the place, and two of them insist on sleeping in my room (of course my door and window are always open); one always sleeps on my chest of drawers, and the other on the clothes basket, so i feel safe that snakes won't come in, as a cat always lets you know when one is about. one night the small tabby brought the most extraordinary creature into my room: it was like a small crab, and it ran round and round in a circle, and squeaked like one of those clock-work mice. the other day it began to rain, and then we were afflicted by a perfect scourge of flying ants, which i had never seen before in such numbers. they covered the walls of our rooms, and some of the sisters could eat no dinner, as they were so thick on the mess-room table. the men in the wards swept them up in bucketfuls; then, in a couple of hours, they all took themselves off again, without any apparent method in their madness. we have all sorts of vegetables and flowers coming on in the garden, the rainy weather suiting them well, but the wet days are rather dull for the men, and there seems to be more sickness starting again up-country. i had a letter from j. the other day from kroonstad, saying that he was fit and well, but heartily sick of trekking about the free state. really _all_ the men seem so tired of the war just now; it is all very well to put up with hardships, and short rations, for a few months, but when it runs on to a year, every one has had enough. the other day we had a wire to ask for a doctor to go to an officer who had been taken ill when on leave about an hour up the line from here. dr. ---- went to see him and found him rather bad, so the next day a stretcher-party went up and brought him here. we have several rather bad cases in just now, but we have plenty of people to look after them, and there is none of the anxiety we had at first, when we were overwhelmed with enteric cases, and the orderlies were so helpless. we hear that lord roberts is coming down this way soon, but there are so many rumours that we hardly know what to believe. xxxviii pinetown, natal, _november _. of course you will have heard that poor prince christian victor died at pretoria of enteric. he was buried in the military cemetery there, and there was a service in the cathedral; i heard it was very impressive--about troops attended. i should like to have been in pretoria when the proclamation declaring the annexation of the transvaal was read. i heard it was very fine. lord roberts arrived with a big escort (including some fine indians), and massed bands played "god save the queen," and then the royal standard was run up, and then again "god save the queen." after that there were no less than six victoria crosses for lord roberts to pin on--he stood on the steps of the old dutch church--and then there was a march past of , troops. i believe the march past took two hours, though the infantry left the square at the "double." it is very difficult to judge, but many people here seem to think the war is by no means over yet; however, if lord roberts does go home, we shall have k. of k. to finish the business. the chief thing of interest here early in the month was some difficulty about the three civil surgeons who were still here (of those who came out with us). there has been some muddle since the government took over the hospital, as to whether they were to have the pay of medical officers engaged at home or of those engaged out here; after some correspondence they were dissatisfied with the terms, and thought they were being hardly treated; and then a wire came that they were to prepare to proceed to england, as their services were no longer required. i expect they will get the matter settled all right when they get home. it was quite a business getting them all packed up in a hurry, and they had to arrange about selling their horses, &c. they gave a farewell dinner-party, which we all attended. the army medical department is a bit unsettling; of course you have to do exactly what you are told, and you are told to do things so suddenly: just a wire comes, and very often next day you move. colonel galway (the p.m.o.) has gone home, and we miss him very much; he has been so particularly nice every time he has been here. we have had a very quiet time lately. they are closing some beds up at maritzburg, and sent us down a very good wardmaster and fifteen r.a.m.c. orderlies--some of them men with six or seven years' service. at first the sisters could hardly realise that these men were really good nurses, as they have been so used to having to do most of the nursing themselves until they had shown each particular orderly how to do things; so they think now that the army sisters, in time of peace, must have a very easy life! one night we had some people to dinner, and then they gave the men such a good concert. some of the orderlies helped--one of them plays the violin beautifully, and the little australian boy "bugled." another day a clergyman, who has a boys' school up the line, brought all his boys down to pay us a visit, and they played a cricket match against the medical officers and orderlies. one other form of amusement has been very popular with the men, though rather an unusual one for hospital patients; we have a lieutenant of the r.a.m.c. on duty here now, and when he went to the remount depot to secure a horse, he was rather surprised that a very nice-looking beast was willingly handed over to him when he said he would like it; but when they got it up here it promptly chucked all the stableboys in turn, and proved to be a bad australian buckjumper! then the men, patients and orderlies, wanted to try their hand with him, and some of the australian bushmen are splendid at sticking on. now he is getting quite tame, and only bucks a little when they first mount. the daily riding of the buckjumper has amused the whole camp; and i should simply have loved to try my hand at sticking on, but my damaged side won't allow me to ride anything for some time yet, though i am getting about my work all right, going slow. they have had a very "mixed" lot of horses out here, and many people seem to think the war might have been over now if they had had a better supply of horses at first. the english chargers have worked awfully well, but the food of the country has not been suitable for them, and the little boer ponies are much better suited for the rough ground and the poor food. they are so used to picking their way on the veldt that they hardly ever put a foot into a hole; and then at night they will peck about and nibble odds and ends at which an english horse turns up his nose. at first the men did not think the boer ponies were big enough to carry the necessary weight, but now they find they are, and that they wear better, because they are not always hungry, as seems to be the case with the unfortunate big horses. still, the good old london 'bus horses have done very useful work with the guns. they have had many horses from new zealand, australia, and the argentine--these last often very bad-tempered beasts. as the men all seem so well satisfied with these boer ponies, it might be a good plan after the war to start a big government breeding station out here, in some bit of healthy grass country. a man told me they could ship horses to england for about £ for the voyage, and that if it was undertaken in a proper way, it ought not to cost more than about £ to rear a horse, or perhaps £ to put a four-year-old on board ship, so they could have one of the best landed in england for under £ , where there is so much trouble about getting the right kind of horses in sufficient numbers. they would be suitable for work in almost any climate, as they have to put up with such rapid changes of temperature here. we have lately had a r.a.m.c. major here, partly as a patient and partly as a visitor. he was in ladysmith through the siege, and had very hard work (so many doctors ill); then he was sent down to a hospital ship as a patient, and very soon the c.o. was called away, and he was put in charge while still ill. he has been three trips in her, and seems to have had a lot of work and worry, and now he is ordered to go up and take charge of a -bed hospital, and is not in the least fit for it. they won't spare any r.a.m.c. men to be invalided home just now, as they seem to want to weed out all the civil surgeons first. this man wants the most careful feeding to get him right; at first i was always running after him with egg flips or some little feed, but now he is beginning to enjoy ordinary food better. i have heard a good deal about the siege from him: he tells me it was awful being responsible for sick men and not being able to get things for them. at one time he had very sick under his charge, and all he could get for them was five, or sometimes six, small tins of condensed milk a day, when they all needed milk. he says that the men had no time to convalesce: it was three days up and out of bed, and then straight to the trenches; the poor fellows were so awfully weak that they used to have to send a mule waggon to cart them down. they put a rifle in their hands, and carted them back again at night. for a short time, too, we had another major for a "rest and feed up"; he is an m.p. when he is at home, but was out here with the yeomanry. he is also on the mend now. i have had the very sweetest puppy given to me--a little black spaniel. he has been christened "bobs," and he follows me about everywhere. i must tell you a little joke about some officers who were here. there is a big convalescent depot at howick, and no one seems to like going there, but at one time we were so full up with officers (and more wanting to come), that the major chose out three or four who were practically well, but not quite fit to rough it at the front yet, and sent them up to howick. we gave them some sandwiches and fruit to console them on the way, and at maritzburg they bought a bottle of champagne, and were having a great lunch in the train. there was one little man in plain clothes in the carriage besides our party, so they invited him to lunch, but he refused. while they were lunching they were all talking about what a good time they had had here, and what hard luck it was that the c.o. had pitched on them to go up to the "home for lost dogs" (as howick is called)--every one said it was a horrid hole, and of course they exaggerated all the bad things they had heard about it. when they got to howick the little man in plain clothes got out, and an orderly came up and saluted and took his bag, and he proved to be the colonel in charge at howick! we sent off sixty men on the st, and, a few days later had seventy men down from standerton, all supposed to be convalescents, but two of them have developed definite enteric, and as they have been at standerton for some time ill with something else, they must have become infected up there. i am afraid enteric is getting rather bad again farther up, but of course there always is more at this season, and they are better prepared to tackle it now. the big hospital at estcourt has been moved up to pretoria, and i believe the beds at maritzburg have been reduced from to ; and now we hear that they are having rather a scare lest they should be short of beds on this side. the other day a man from the ordnance department came up to see about putting new sinks in the theatre and otherwise improving the buildings, so that does not look as though we were to close just yet; but i think if the place is kept going into the new year they are bound to send an army superintendent in my place, as it would be too "irregular" to leave me here now that there are so many army sisters about (with some hospitals already closed), and not by any means all of them acting as superintendents. xxxix s.s. "canada" between cape town and st. helena, _december _. we have had an exciting time since i last wrote to you; i had better begin at the beginning, and tell you of the upheaval. at the beginning of the month we heard that the p.m.o. was hovering near, so we thought he would come to inspect us, and then we should learn our fate. instead of that, one sunday our major had a wire asking him to go down to see the p.m.o. in durban the next morning "on urgent business." every one was so excited on monday they did not know how to work, and i saw that all the medical officers were ready to waylay the poor major as soon as he got back, so i kept out of the way, thinking he would be tired, and that we should hear the news after he had had some tea. but very soon he came to my room and said, "well, sister, would you like to go to england to-morrow?" i only _said_, "no, sir, not particularly; i think it would be rather cold there just now, and i should like to see the war through," but i _thought_ to myself, "what has gone wrong that he wants to ship me off?" because we had worried through some very thick times of difficulties together; but then he explained to me that _he_ had been chosen to go home in charge of the sick on the ship on which lord roberts was to go--the _canada_--and he was to choose two sisters and some good orderlies to take with him; he thought the trip would do me good, as i had not been really well since my accident, and he thought i could certainly come out again if i wished, but (of course) i should very likely not get back here as superintendent. i did not mind that at all, as for some time i had been keen on seeing some work farther up-country, and it seems likely that this place will become more of a "rest camp," and less of an acute hospital as time goes on. anyhow, he seemed to wish me to go with him, so in ten minutes i had made up my mind to go, and we had decided to take sister ---- (one of our original batch of sisters) with us; and then there were the orderlies to choose. it was . p.m. on monday when i got my marching orders, and the major had to leave the next day at . , and we to follow him at . p.m., so you can imagine we had a rush, and there was little sleep for us that night. the r.a.m.c. lieutenant was put in temporary charge until the p.m.o. could send a major down; my senior sister took over the superintendent's duty for me, and i had to show her all the details about the mess accounts, stores, linen, washing, &c.; arrange to send my dog back to the people who had given him to me (as i should not have been able to land him in england); send my saddle up to maritzburg to be sold, so as to make room in my saddle-box for packing curios, &c.; to say nothing of my own packing up, and heaps of other things to arrange about. i could not go to see any of the many friends who had been so kind to us; but before the ship sailed i was able to write fifteen letters of farewell and apologies, and managed to send them ashore. there was a good deal to settle about the servants too: our good madrassee cook was to leave the next day, and all the black boys said they "no stay if the big boss and the little missus go to england"; but perhaps they will settle down again. all the orderlies came crowding down to the station to see us off, and gave us such cheers; and john and the other black boys were all mopping their eyes, charlie holding on to my little bobs, who was whining and struggling to come with me--but he will go back to a very good home. when we got on board at durban we found the ship had to go to the outer anchorage. we were disappointed that we could not even go up the town to say good-byes, and really we might have had another night ashore, as lord roberts never came down till the next day. our good friend, mr. t., from pinetown, kindly came on board to say good-bye, and brought us a lovely hamper of flowers, some of which we arranged in lord roberts' cabin. fifty men were to leave the day after we did, so they will be very light in the hospital, and the p.m.o. said he should not send more down till he had settled the staff. lord roberts came on board with his staff at p.m. on december th, and we sailed at once. only troops came on board at durban, but we heard we should have after cape town. the _canada_ is a splendid boat, with the finest stretch of upper deck that i have seen on any ship. from durban to cape town the saloon was very empty; besides sister and myself there was only one lady on board, the wife of a chaplain from wynberg--they have been to ceylon for a trip with a shipload of boer prisoners. besides lord roberts, we have on board general ian hamilton, general kelly-kenny, general marshall, lord stanley, and others. i was shown a copy of the orders about the medical company to be put on board this ship: it read, "to include two specially selected sisters"--it sounded like choosing turkeys for christmas! there is a hospital with eighty-four cots on board, but, as the men were supposed to be chiefly time-expired men and not sick troops, we did not expect very much work. we had fine weather coming round the coast, and lord roberts went ashore to receive addresses both at east london and at port elizabeth; after port elizabeth there was a very heavy swell till we reached cape town, and poor sister ---- was so bad we were quite glad the hospital was still empty. before we reached cape town lord roberts came up to speak to me, and we had quite a long chat; he was very anxious that we should have everything that we wanted for the hospital. he told me that lady roberts and his two daughters would join us at cape town; and two sisters who have been nursing her are coming home with the miss roberts who has been ill. at cape town lord roberts had a great reception, of which i got some good photos. when i could get away from the ship i went up the town and wired to my brother in kimberley, to tell him that i was going home, but after doing so i thought i might as well inquire whether, by any chance, he was down in cape town, so i went to his club, and was much surprised to find he was in the town; so i left a note to arrange to meet him next day. the next day was sunday, and sister and i went to service in the cathedral (which lord roberts attended with his staff), and then my brother met us, and took us up to an excellent lunch at mount nelson hotel. after lunch sister ---- went off to see some friends at wynberg, and my brother and i went to see various friends in the suburbs, and finished up with supper with the s.'s at their lovely kenilworth home. it was nice meeting so many old friends; and then i went back to sleep on board. the next morning i made a raid on the red cross society and the "absent minded beggar" people to beg for games, cards, books, tobacco, &c., for the men on the way home; and in a few hours' time they sent me on a splendid supply. then it was "ladies' day" at the club, so i found time to run up to lunch with my brother there, and he had some old kimberley friends also lunching with him. after that the troops were coming on board, so i had to go back to duty. i was appointed lady superintendent for the voyage, and two more sisters were sent on to help us--also three roman catholic sisters who had been nursing in bloemfontein, had a passage home on the _canada_, and were to be "available for duty" if i wanted them. the cape town people gave lord roberts a great send off on december th, and h.m.s. _doris_ escorted us out to sea. we have very comfortable cabins, and the major (who is p.m.o. on board) invited sister ---- and me to sit at his table in the saloon with four other officers, so we are well looked after. a great many of the men are wounded, some of them going home for operations. we had twenty sent straight into the hospital before we sailed, and we soon began to fill up there and to get busy. before we reached st. helena one poor fellow of the yeomanry had died; he did not seem particularly bad when he came on board, but he came down to the hospital saying he felt "a bit queer"; his temperature was only °, but we admitted him at once, and he was evidently just beginning a relapse (enteric), and then he had a dreadful septic abscess and other complications, so we had to isolate him in a little cabin, to reach which we had to go past all the stables--there were several horses on board, including the charger poor lieutenant roberts was riding when he fell. he was so bad one evening that sister ---- volunteered to sit up with him, but when i went to relieve her at a.m. we could both see that he was dying, and sister offered to stay so that i should not infect myself; but she looked so done up (she is a bad sailor) i thought she had had enough, and the other sisters could quite well manage the hospital, so i sent her to disinfect, and go to bed. the poor man died about a.m., and was buried in the afternoon, lord roberts and all his staff attending. i don't think anything is more solemn than a funeral at sea; the slow march out to the stern, and the service read, and then the engines stop, and there is such a hush when the constant beat of the screw ceases; next the little splash as the body, heavily weighted and sewn up in a blanket, slides into the sea, and then the mournful "last post" sounded: once more the engines start, and we all go back to our posts. i did not put on a regular night sister except when there was special need; but we took it in turns to be responsible for a night at a time, and the responsible one stayed up till twelve, and then (if all was quiet) turned in, and was called again at a.m. to take a look round; but if she was kept up much, we relieved her from duty for the next morning; we had very good orderlies, and we found this plan worked well. xl s.s. "canada" (nearing st. helena, on return voyage to the cape), _january _. i am now on my way back to the cape after sixteen days' leave in england; a rushing time, amid snow and sleet; but i must first tell you about the voyage home. we reached st. helena on december th, and lord roberts and nearly every one went ashore for a few hours. i did not go off as i was busy in the hospital. several men were very ill with enteric, and one with double pneumonia; of course it was frightfully stuffy for them in the hospital, but lord roberts had most kindly said that we were to use part of the upper deck (that had been reserved for him and his family), if it would be any better for the men; so we rigged up a screen, and put two or three men, who seemed most in need of fresh air, up there, and they were so grateful. there was always a good supply of ice, and the sterilised milk was good; one man (who was very ill) could not take it, but for him i was able to get fresh milk, as there were two cows on board. the "skoff" for the convalescents was excellent, and they were all delighted with the variety of food supplied by the company, after the sameness of the army rations. both the ship's officers and the stewards were most kind in every way in helping me to get what i wanted for the men. we had a spell of very hot weather between the th and the st, and on the th we had another sad death, a young st. john's ambulance man, who was admitted on the th with acute rheumatism (he had had enteric in south africa). it was my night on duty, and at . i did not think he seemed so well, and i found his temperature had run up to °, and his pulse was very bad; we did everything that was possible for the poor boy, but his temperature continued to rise and his heart to fail; he was dreadfully breathless, and it was so difficult to prop him up enough in the bunks; by a.m. his temperature had reached . °, and he knew that he was dying, and was able to tell me where to write to his mother. he died very soon after. it was dreadfully sad for the other men, as, of course, they were all awake, and in such terribly close quarters--one man in the bunk above him, and two more close beside him; and it does seem such hard luck for these two men to have got through their time in south africa and then to knock over just when they are nearing home. a nice sergeant in a bunk near by saw that i was very much cut up about this poor boy, and said, "never mind, sister, no one could have done more for the poor lad to give him a chance than you have; but i know i have seen many men die on the battlefield, but it's a lot worse to see one die between decks here." afterwards we carried him out to a small bathroom, and he was buried the next day. i found one of the patients in the hospital was a bart.'s student who had been serving at the front. both lord and lady roberts took a great interest in the men, and lord roberts used to come up to me in the morning and ask how they had got through the night; and he would ask after the men who were especially ill by name: of course they were awfully pleased when i told them. they both went round the hospital several times, and on christmas day they went down and shook hands with all the men in hospital, wishing them a happy day, and then they sent down a large sugared cake and some chocolate for the men who were well enough to enjoy it, and the very sick ones all had some champagne; the men appreciated it very much, and there was a great demand for envelopes to take "a bit of bobs' cake home." many of the beautiful baskets of flowers that came on board for lady roberts at the different ports found their way down to the hospital, and the men especially treasured a beautiful union jack that came on board at madeira, made of red geraniums and blue and white violets. by the nd it had become cooler and rather damp, so all the men returned to the hospital (from the upper deck). on the th one of the officer patients had to have an anæsthetic for a slight operation on his arm; and i had a busy night in the hospital, as one man had a fit, and there were several enterics very ill. on christmas day it was good to see about twenty officers and between forty and fifty men at the early communion service, and we also had a service in the hospital. the saloon was quite full for the morning services at . and at a.m.--there were too many for all to attend one service. sister and i found two huge stockings on our plates at breakfast time, with all sorts of silly presents in them. we had a very pleasant day and a jolly dinner party at night. we reached madeira that evening, and did not leave again till p.m. the next day, so i had a run ashore with some people in the morning. on the th we anchored at gibraltar at . a.m., and the guns thundered out such a welcome to lord roberts! we stayed there till p.m. the next day, and i again went ashore with some friends, and had a good look round the town. sir george white and his daughter came on board, and afterwards lord and lady roberts went ashore. we had fairly good weather all the way home, but after gibraltar the ship was rather inclined to roll; the remark on the ship's log was "fresh to moderate gale, with confused (!) sea." two of the sisters were rather bad, so the remaining sister and i had a busy time between the sick officers and the hospital; and, though neither of us was sea-sick, i can't say that we exactly enjoyed it when we had to sponge a bad typhoid in an upper berth (to reach whom we had to stand on a box, and have a man wedged in the gangway to hold our basin of water; never quite sure whether the next roll would not oblige him to pitch all the water over either us or our patient); and the daily syringing of the arm of the officer who had the operation was just about as much as i could stand on the rough days; so we were glad when the wind abated, and all the sisters could take their turn for night duty, &c. lord roberts was awfully nice to me about having looked after the men on board, and he asked me whether i wanted anything he could help me with; so i told him i only wanted to be sure they would let me go back and do some more work, and not get sent to a home station; so he most kindly sent for his secretary, and asked him to write to the director-general to say he would be obliged if my wishes on this point could be attended to. was it not kind of him? if i had not been so surprised i should have asked to be allowed to work for the same major again, but he was just chatting in such a kind, informal way on the deck, that i did not realise how much he could have helped me if i had thought to ask. i saw the new year in down in the hospital, and the stokers made such a noise to celebrate it, beating with their shovels, &c. luckily, by then, all our patients were improving, though some of them were still very ill; all except the very sick ones were tremendously excited at the thought of getting home. we were rather before our time, so, on the evening of january st, we had to anchor in swanage bay, and then arrived and anchored off cowes the next morning at a.m. it was freezing hard and bitterly cold, and we were all longing to get home; but in the afternoon lord roberts went ashore to be received by queen victoria at osborne. he returned an earl and a knight of the garter, and i believe the queen handed him the v.c. won by his son at colenso. that night we anchored off netley, and the cold was intense; we got up to southampton at . a.m. on january rd, and such a crowd was there to welcome lord roberts. of course it was some time before he got away and we could get our patients landed; but as soon as we got into dock some orderlies came on board from netley with a good supply of fresh milk, which was much enjoyed in the hospital, and, eventually, we were thankful to see all the bad cases safely off to netley--three of them had been so very ill, and several times we had thought they could not live to get home. it is always a little sad saying good-bye to people you have got to know well on board ship, but not nearly so bad near home as out at the front. we had orders to report ourselves at the war office, and, after having cleared up the hospital, we were able to get away about p.m. the next day i called at the war office, and presented lord roberts' letter, and was told that i should go back; they would let me know when--and then i went on leave. on the th of january i had a wire to rejoin the ship for the return voyage on the th. it was bitterly cold all the time i was in england, and i had rather a rush to get some new uniform and other necessaries, to unpack and "sort myself," and repack again. when i got on board the _canada_ i was rejoiced to find that sister ---- was returning too, and three of our original medical officers. the ship was very full ( in the saloon), and there were sixteen sisters and one other lady; but my old friend, the stewardess, was kind enough to manoeuvre so that i got a small cabin to myself. just before we got away the _manhattan_ backed into our stern, and sent us first with such a bang against the wharf, that the people standing there fell down flat like ninepins (and it was raining, so there were inches of mud for them to fall into!); and then we broke away from our moorings, with some visitors and the embarkation officers still on board. after a little excitement they managed to anchor off netley, and found our damage was chiefly to the boat deck (one boat was stove in) and the railings--it would have been more serious if our steam had not been up and ready for us to get away, so they were able to get her under control at once--but there we had to remain all the next day repairing, and it was very tantalising having to waste that time on board, especially as i have some relations who live within a couple of miles of where we were anchored. before we sailed we heard that the queen was very ill, and i fear she has been very feeble lately, and very much troubled about the war; so we all feel anxious, and every night when the band plays "god save the queen," and all stand at the salute, we wonder how she is. xli s.s. "victorian" (between cape town and durban), _february _. just as we got in sight of st. helena on february nd our engines broke down, and we had to lay to for some hours while they were being repaired. then, as we steamed slowly up to the anchorage, h.m.s. _thetis_ signalled to us that our queen had died on january nd; so we ought to have been singing "god save the _king_" for the past eleven days. the men were all joking and playing games, &c., when the news came, and then there was such a hush of sorrow on the boat, and all the games were put away. we were at st. helena all the next day while the repairs were going on. the _mongolian_ arrived with boer prisoners, and last week they had from simon's town. since we were last here some of the prisoners had made an attempt at escape, and they had also had a nasty mutiny amongst the men of the west indian regiment, who were stationed there. we anchored in table bay, after a very uneventful voyage (with no work in the hospital, except five cases of german measles), on february th, but did not get alongside till the following evening; and then (as we were receiving fresh orders about every half hour) we stayed quietly on board till the th--when the _canada_ was sailing again. the only thing that was definite was that the medical officers and sisters who had been in natal before were to return to that command, but how to get there was a different matter; the ship by which they proposed to send us by was not yet in, and it seemed likely that when the _canada_ left we should remain on the wharf sitting on our boxes. sister ---- and i were the only sisters who had been in natal before, so we saw the others off by train for pretoria and elandsfontein. then the _city of vienna_ came in, and she was so full she could only just take on the medical officers, and sister and i had to wait to go by some other boat; but we were told we could go out to wynberg and lodge at the hospital till they could find berths for us, leaving our heavy baggage in store at the docks. there we were kept waiting ten days for a ship, and had a very dull time of it, as we were afraid to go to any distance in case any sudden orders came for us. wynberg is a very pretty place in pine woods; but the huts were infested with creatures, so that sleep was difficult, and though we are neither of us very particular about our food, it was so badly served and dirty that we could not enjoy it. i can't understand about the mess, as the sisters have to pay all their allowance of s. a week for food, and don't get anything like such good food as we had at a cost of s. or s. a week (though the actual cost of food is less at cape town), and they have no variety. there were some pretoria sisters staying there to recruit after enteric, and i felt so sorry for them, as the food was absolutely unsuitable for convalescents; and they told me they had been very well cared for all the time they were ill at pretoria, and so they were missing the careful feeding they had been used to. of course we did not get to know really very much about the hospital, as we were not on duty, and were only "lodgers," but a sister who came out with us was on duty, and was not at all happy; there were so many petty rules for the sisters that they seemed to spend their time in trying to evade them--not a good hospital tone. we found no news at all in the cape town papers, but certainly the war does not seem likely to be over just yet; they say all civil traffic and mails north of de aar have been stopped. there was a rumour that there were boers within thirty miles of cape town, so all the boer prisoners were being sent away from simon's town. some naval guns have been mounted on the "lion's head" (a part of table mountain), and the town guard were sent up there in watches, as well as some of the regulars. the town guard were most energetic and constantly drilling. one day i wanted to speak to one of the customs' men, and found they were all drilling with their rifles in the customs' shed, and the customs' business had to wait. then, of course, you will have heard there was plague in cape town, and there was some alarm lest it should get amongst the soldiers, and cripple us in that way; but they seem to be attacking it in an energetic way, and so far it is practically confined to the coloured people. as usual it started among the rats on the south arm at the docks; large numbers of them died, and the rest went off in a body to green point, at which place there is a large military camp, so that the sanitary officials were rather anxious. then the natives got frightened, and wanted to go home; but the government stopped that by not allowing any of them to travel by train, except with special permits; this was partly to prevent their spreading the plague about the country, and also because it would have been difficult to get the dock work done if the natives had cleared. at the same time a large native location is being built on the cape flats (where they will all have to live), and a light railway to bring them into their work. rats are being bought for threepence each, and several hundreds of their bodies are being cremated daily at the gasworks. at last we went into cape town and saw the p.m.o., but he said he could not say when we should get on; so we went on to our friend the embarkation officer, and told him that if there was no transport coming soon, we would pay our own passage to go up to natal by a mailboat rather than waste more time at wynberg; but he promised we should get a ship before the next mail and save our money, which we were glad enough to do; but my private opinion is that we should have been waiting at wynberg still if we had not gone into cape town and agitated about it! we paid a visit to the yeomanry hospital at maitland, where a brother of sister's was in as a patient (but getting better), and i found several old friends on the staff there. at last, on the th, we received orders to join the _victorian_ at cape town. it was pouring with rain, but sister ---- went off at once to find a cab, while i hastily packed up, paid our mess bill, &c. before she got back, there was a telephone message to tell us to hurry, as the ship was going soon; we bundled our things on to the cab, and just managed to catch a train at wynberg, which (by good luck) was an express, as most of the trains loiter about at all the suburban stations. at cape town we hastily cabbed to the p.m.o.'s office for orders, but were told to go straight down to the ship; at the dock gates i sent sister on with our small things to the ship, to say we were coming, while i went to the agents, and was lucky in finding an empty trolley, and getting them to tumble our heavy baggage on to it, though they said it was too late for the _victorian_, as she had been hooting for some time; however, i got on to the waggon and rattled down to the south arm. there i found sister ---- looking very melancholy, as they told her on board we were not expected, and there was no room for us, and "where were our written orders?" of course we _had_ no written orders, as all had been by telephone; but i did not mean to be left behind, so, taking my bag, and telling sister to bring hers, i bundled up the gangway, which they were on the point of removing, and asked to see the c.o., telling them that i did not mind a bit if there was no cabin, but that we could travel on deck! just then the embarkation officer came bustling along, and said that he had thought we could not get down in time, but that it was all right, and they had got to make room for us! so some soldiers soon carried our baggage on board, and as our last box came on the embarkation officer went off, and we were away. the cabins were really all full, but, after some delay, two poor young officers had to double in with some others and give us their cabin. the _victorian_ is rather a grubby boat--a cattle-boat when she is at home. there are two hundred boer prisoners on board, going up to a place near ladysmith; four of them are officers, who are berthed on the upper deck, but don't mess with us. they seem quite a superior sort (one of them was a commandant), and they are very polite to us, always ready to move our chairs, or to do anything to help us. there are about twenty officers in the saloon, and one officer's wife. the ship is not accustomed to having any ladies on board, but every one is very good to us, and the stewards are most attentive (there is no stewardess). i sit next to the c.o., a colonel from australia, who had had a bad fall from his horse, and is going back to australia for the voyage to recruit (this boat is going to take time-expired men from durban to australia, and will return with a full load of men and horses from there); he and his son have both been fighting out here. just lately he has been a patient in the hospital where we have been lodging, and he speaks very plainly about the bad management there, after he had been very well nursed in another hospital up-country. there is a very pleasant, and very irish, r.a.m.c. major in medical charge. he has had a rough time trekking about with his regiment for the last fifteen months, and is now going for the trip to australia to recruit after fever; he wants us to go with him, as they will probably send a couple of sisters, and we already have the promise of "a good time" in australia while the ship is there; sister says she would like to go, but i would like to see this show through first. the officer's wife has been in her cabin sea-sick all the way, so we have had to look after her a bit. it has been a little rough, but even sister ---- has kept well--we conclude because we had been doing a compulsory fast in consequence of the bad feeding at wynberg before we came on board! we should have thought the feeding on this boat very poor after the _canada_, but it is first rate after wynberg. we shall soon be at durban now, and then they say we may have to be quarantined outside for ten days (on account of the plague at the cape), but we hope our services may be so urgently required at the front that they may forget to quarantine us! xlii general hospital, natal, _march _. we arrived at durban on february rd, and were eventually allowed to land without being quarantined. it was saturday afternoon, and no orders came on board for us, and by the time the boer prisoners were landed, and we were able to get our baggage ashore, the durban p.m.o. had left his office; so we felt free to do as we pleased till the following day, when (though sunday) we _might_ be able to report ourselves. if we had been new sisters arriving it might have been awkward, but it suited us down to the ground. sister ---- just caught the evening train up to pinetown to stay with some friends, and i promised to wire to her if we were needed on sunday; otherwise she would return on monday. then a kind sergeant-major helped me to get our baggage on to a trolley and take it up to the medical store, where it would be quite safe; and after that i went up to see some friends on the berea, and they most kindly took me in. from them i learnt many things; amongst others, that our old hospital had been turned into a rest camp of beds, and that they thought we were to have the chance of going back there, but, for various reasons, they strongly advised us not to do so if we could avoid it; that our late medical officers had already been sent farther up-country (we had hoped to work for them again, but did not succeed in doing so). on sunday morning i went to report "ourselves" to major ----, and he was very pleasant and kind, wanted to hear all about our voyage home, &c., and asked me where we wanted to go? so i told him "as near up to the front as we could get"; then he told me that the order from the natal p.m.o. was for us to return to pinetown, but if i liked he would wire to him to ask him to let us go up-country, and that we could stay with our friends till he got a reply. i had a quiet sunday in durban, meeting many friends, and going to church in the evening. the next morning i met sister at the station, and the first thing she said to me (before i could tell her the orders) was, "sister, i _won't_ go to pinetown, i would rather resign, if they want to send us there." so then i told her that our fate was waiting on a wire from the p.m.o.; and as we walked along to the office she told me a good deal of what she had heard about pinetown--of course we can scarcely judge how much of it is really true, but at any rate it appears that some of the sisters now there seem to think that they have come out to south africa only to enjoy themselves, and that they are setting about it in a way which no lady would care to emulate. it was rather strange that we should both have received the same advice from quite different sources: "don't go there." together we went to the office, and stayed there some time, but no wire had come; they thought we should probably go _somewhere_ by the p.m. mail train. we were advised to take some food if we went up, as meals on the way were uncertain. so i stocked my tea-basket, and bought some potted meat, &c., in case we went. all day we had to hover near the office or within sound of the telephone, and at p.m. a wire came for us to go up to no. -- general hospital by the mail train. one of the medical officers kindly helped us to get our baggage to the station, and secured a carriage for us. it is always a shaky journey up from durban, but we got some sleep, and the next morning, when we were having breakfast at glencoe, we were delighted to meet major ----, of the royal engineers, an old patient of ours, who has done splendid work up this side; he was going down to ladysmith. a little farther on we met two officers who had come out in the _canada_ with us, so they came into our carriage, and shared our lunch, and we brewed some tea with my tea-basket. at newcastle general hilliard was on the platform, and also a sister whom we knew. we had no sooner reached our destination than sergeant c. came up to welcome us--he had been at pinetown--and also went home with us; he does not seem at all pleased at being sent here, and is already trying to get a change. this hospital has been a "stationary hospital" up to now, but is just being turned into a "general hospital," so they say it is in rather a muddle at present. sister ---- and i were allotted a tent with just bed and blankets--nothing else; we were not required on duty that day, so we went down to the coolie store and invested in some cheap sheets, a bucket, basin, &c.; also table fittings, as they told us no plates, cups, knives, or anything were provided. many people out here prefer to sleep in blankets, but as the army blankets are dark brown, rather of the texture of horsecloths, and as these were obviously not new (and the washing and disinfecting of army blankets in a satisfactory way is still an unsolved problem out here), we preferred to put some sheets in between! the air is lovely and fresh up here, where we are feet above the sea-level--always hot sun in the day, but very cold nights. a most unfortunate thing occurred the first night we were here: a sister, who came out in the _canada_ with us, had two large cases of feather cushions given her by the princess of wales--whom we must now learn to call queen alexandra--with the request that they should go to men in hospital near up to the front. she had promised me that if i went up-country i should have one of the boxes to distribute. when we arrived here i found a wire from her saying that she was passing our station about . p.m., and would i meet her? she was one of the sisters who had landed at cape town, but was now coming down to a hospital on this side. so, when we had got our tent straight, we went to the lady superintendent and said that if we were really not wanted on duty, might we go down to the station after dinner to meet this sister? she said certainly we might; she was sorry she had some letters to write, or she would have walked down with us. when we got to the station we found we were rather too soon, and there were a lot of orderlies standing about, and a few officers (whom, of course, we did not know), so i said to sister, "i vote we walk about outside till we hear the train coming"; and we were just beating a retreat from the platform when an officer stalked up and said, in a very rude way, "who are you?" we just gave our names, and were walking away, when he again stopped us, and asked what we wanted at the station? by this time sister ---- was bubbling over with wrath, but we had to explain that we had obtained leave to meet a sister. i believe if i had said that i was expecting a box of things from the queen, he would have knuckled under, but i was not going to trade on that; and the long and short of it was that he did not believe that we had been given leave, and said we were not allowed in the station and were to return to camp. of course we went back furious at his rudeness, and then discovered he was the c.o. here! i expect the lady superintendent had forgotten to tell him we had leave (or something of that kind), but he might have believed our word, and not been so rude to us before a lot of orderlies, and she was very much annoyed with him. the next morning, when we were formally introduced to him, he was, i think, penitent, and invited us to go out for a picnic on the following day, when some people whom we knew were coming here, partly to inspect the hospital and partly for this excursion. sister ---- went with them, but i was going on night duty that night, so i begged off. this is a "ration station" (as it would be difficult to buy food privately so far from the base), therefore we don't get quite so many "allowances," but the "skoff" seems very fairly good; they bake bread in the camp; and as long as you can get decent bread you can be content. we are just on the border of the transvaal, and there are plenty of boers about; two or three of our columns are trekking about in the district, and they say that we often have sick and wounded sent in from them. most of the sisters here seem to ride, but i can't take to that again yet. the night sisters had a little excitement two nights ago, when two horses galloped into the camp, and they--with the help of a convalescent officer--caught and tethered them. they hoped they would be allowed to keep them, but, unfortunately, they were reclaimed by some yeomanry men; but they say that very often droves of horses pass here, and sometimes a few escape, or are left behind too sick (or too tired) to go on; and then the orderlies catch them and sell them to the sisters for £ or £ ! i think there are about beds here, nearly all under canvas. there are a few buildings of wood, and amongst them is a small room that the sisters use as a duty room, and the night sisters (two of them) sit there, and they have a small stove for boiling water, &c. there is no arrangement for hot water near the tents for the patients--we used to have (and i have seen them in other hospitals too) boilers on wheels with a coolie to keep the fire going, and if the water was not always hot, the coolie soon heard about it from the orderlies. one day the c.o. asked me whether i had everything i wanted, and i said, "no, i wanted a good many things for the men, one being hot water"; but he said he had never heard of these movable boilers, and seemed to think them an unnecessary luxury. at the sisters' camp we have a comfortable room that they use as a sitting-room, with a mixed lot of furniture that has been "commandeered" from houses in the district. the other day an officer sent us a lot of china plates taken from a boer hotel; they were very welcome, as we were most of us using enamel plates out of our tea-baskets, &c. we have our meals in a tent--just a long table, and benches without backs. our sleeping tents are chiefly the big square kind, called e. p. tents; they are supposed to hold four beds, so we may have to pack tight, but at present sister and i are alone. some of the sisters have made their tents very nice, and have rigged up curtains to divide them. at present we use our boxes as washstand, &c., and as a general hospital is given a certain amount of furniture for the sisters, we intend not to buy anything that is not really necessary until we see what they are going to give us. xliii general hospital, natal, _march _. now i have waded (both literally and figuratively) through my first spell of a fortnight on night duty, and it has not been pleasant; but when one thinks how much worse it must be for the troops out trekking, one does not mind. i have always thought that south africa _without the sun_ was rather a poor sort of a place, and, living in a tent in the wet season, i am confirmed in that opinion. it began to rain the first night i went on duty, and during the fortnight i had only four fine nights: the other nights it rained--generally in bucketfuls. the first day when i went to bed it was very hot and stuffy in the tent, so i did not sleep for some time, but was sleeping in the afternoon when the rain began, and soon it woke me up by splashing on my face; then i found it was coming down in torrents, and our tent had been so badly pitched, with no trench round it, that there was a deep stream flowing through. i had to paddle about and rescue all our goods from the floor, pitching most of them on to sister's bed; and she was rather amused when she came over to call me, to find me fast asleep under a mackintosh and umbrella, my bed a simple island, and no room for her to get into her own bed! most of the sisters were prepared for this, and had suitable garments, but it was several days before i could obtain them, so i very soon had not a dry garment to my name. before i leave the subject i may as well tell you what is the correct garb, and then you can imagine us sitting on a bench at our mess--and i am sure no one seeing us would think we were sisters; with our lanterns hung up behind us, we look more like miners, or something of that sort! the first essential is a pair of knee "gum" boots, as the grass between the tents is long; then you must have knickerbockers, with a very short serge skirt (some omit the skirt altogether on night duty!), then a mackintosh. when it does not rain, you substitute for the mackintosh a "british warmer" coat--that is the short khaki overcoat that both officers and privates wear, a very rough wool with a warm flannel lining. for headgear we have a sailor hat, or a wool cap, or a sou'wester, according to taste. white caps and aprons are quite impossible when you have to go from tent to tent. of course there is no chance of drying anything till the sun comes out again, and when we get out of bed it would never do to turn it down; instead of that you put anything you wish to _try_ to keep dry inside, and cover it all up with every rug and blanket and mackintosh that you can lay hands on. our tent was so hopelessly bad, that after some days they let us move into another, and that one having a wooden floor, we were better off. i was so tired after moving our things into the new tent, and after a heavy night on duty in the pouring rain, that i slept like a top, and when i woke in the evening i found everything upset in the tent, and evident marks that a cow had been taking shelter with me! the sisters gibed at me, and said i should probably not have waked up if it had been a boer commando. there are a lot of men very ill. i was supposed to have charge on night duty of the medical side (about beds), and that included the enteric tents with about beds. they seem to have a mania for shifting the men about, so it was often difficult to find the bad cases; there were generally only night orderlies in the enteric tents, so that men who needed much attention in the night were supposed to be sent to the enteric line, whether they had enteric or not. to escape this risk of infection for them, we sisters used to try to do all for them in their own tents as long as we possibly could, and the poor chaps were so grateful to us, and the day sisters (who were equally keen not to have them sent down) used to tell us that the men always assured the medical officers that they had everything they wanted in the night. you know how at home if a sick man wakes up, and is alone for a few minutes, he thinks he is being neglected, but these poor chaps must have many lonely hours in the dark tents, and yet they never complain; they know that so many are dying of enteric, and they seem to have a horror of being sent down to that line. it really was pretty horrid paddling about in the dark and the long grass between the tents; and it was so slippery with mud and rain that twice i fell down, and it took some time before i could find my lantern and the kettle which i had just boiled up, and was carrying down to make a poultice for a poor chap with pneumonia: it was very annoying, as, of course, it took time to reboil the kettle. the day sister leaves everything ready, with the linseed in a bowl, so that i have only to pour the water on, and then i put everything all ready for the next one; in this way we can get fairly hot poultices, though the tents are a long way from the fire. the men used to be so sorry for us being so constantly wet; and many a convalescent man used to beg me to let him stay awake with a man who was very ill and give him his drinks, &c., promising to come and fetch me if he wanted anything, so that i need not go round so often,--but, of course, i could not let him do that. one man (a new zealander) said to me, "well, sister, i have often grumbled at having to do sentry-go for two or three hours on a wet night, but i never knew that any woman had to do it for twelve hours at a stretch; i shan't grumble at my share again in a hurry." the other day we had in a big convoy of eighty sick and wounded from general french's column. they had been eight days in ox waggons coming seventy-two miles; poor chaps, they were glad to get into beds. two days from here they had got stuck in a drift one night, and the boers came down and fired on them, killing a corporal and a private of the guard and wounding two others. one man had been shot in the thigh, and sister made him comfortable in bed, and the doctor said they should not do anything till next day; the man slept like a top for over twelve hours, and when he woke in the morning sister said something to him about having been comfortable, and he said, "yes, sister, i was not going to miss five minutes' enjoyment of that bed, for i have not been on a bed for fifteen months." this convoy also brought in a lot of boer women and children, but they have gone into a camp about three miles from here. if you, or any of your friends, care to post me any illustrated papers or magazines, they would be most gratefully received, or in fact anything wherewith to amuse the men. we should be very glad, too, of warm garments, as the winter is coming on, and the red cross people have stopped sending the splendid big bundles of papers that our men used to appreciate so much; in fact, most people seem to have tired of sending the things with which we were so well supplied at first. the poor tommies feel a little hurt at no free supplies of tobacco or cigarettes, and i would give anything to have my old supply of warm shirts, sweaters, wool caps, &c., for the men who have to go back to roughing it on trek. now that the rain has stopped, we are having perfectly lovely days, but the nights are very cold; they say that a little later on it is bitterly cold up here. there were six deaths during my first fortnight on night duty, and it was awfully sad, as one felt they had so little chance, and i cannot really see why they should not be better "done by"; but the sisters seem to think that it is the natural order of things, and that we must just "do our best and leave the rest." the general was here the other day, and said that all the men were to have tumblers instead of mugs, but i suppose he does not know that they have not each got a mug yet! there is one enteric tent (the last one opened) of fourteen beds, and their equipment includes only four mugs, and not a single feeding-cup at all. one night i found a man, who had not got enteric, sent there for the sake of having night orderlies, as he was very ill; so i had to borrow a mug for him from another line, and the next day i bought him the necessary fittings at the coolie store; but it won't do much good, as the orderlies probably won't take proper precautions to wash up for him separately. there are some new r.a.m.c. officers here now, and one of them seems energetic; i don't know what had gone wrong that he was poking into, but one of the sisters heard him say to a sergeant, "hospital scandals are not in it," so we can only hope things will improve here. there was much excitement here one night. a major arrived, sick, in a mule buggy from a column near here; the c.o. saw him, and told him what tent to go to, but he never arrived. after much searching of the camp, neither the officer nor his mules could be found; then the heliograph was set to work, and eventually he was located at the next station, and when he was brought back he said the c.o. was so rude to him that he thought he would not stay, and had gone to a hotel! since i came off night duty i, and two other sisters, have been doing only "afternoon duty," which means looking after the camp while all the other sisters are off duty; this is because there are more sisters here than the proper number: if there were only the right number, two of the sisters who have lines would stay on every afternoon in turn; but the stupid thing about it is that if we were each turned on to a big tent of enterics (instead of one sister having all the line on her hands) we might be doing really useful nursing; as it is, there is not much to do in the afternoon, beyond prowling round and trying to talk to the men and cheer them up a bit. the other day one of them presented me with these lines of his own composition; he was in a tent when i was on night duty where there was a very bad case: (_by an australian trooper._) you may talk of our soldiers and sailors, of our brave colonials too, but nothing is thought of our nurses, with hearts so tender and true. they have suffered great hardships, and endured the trials that fell to their share, and so caused their names to be cherished on every barrack room square. so give three cheers for our sisters who've shown us what they will do to help the cause of old england by nursing our sick soldiers through. xliv general hospital, natal, _april _. our tent has filled up now--four of us in it--so we feel rather tightly packed. one of the four is a sister who has been in india, and done some camping out, so she thinks she knows all about tents and how to live in them; we rather trade on this, and when it rains we assure her she ought to go round and slack the guy-ropes in case they should shrink with the wet and pull the pegs up, as she knows so much more about how to do it than we do; or if it comes on to blow in the night we wake her up, and offer her the hammer to go round and knock in the tent-pegs! the wind gets up so suddenly here that we have to be careful not to leave anything about that is not tethered, or it may be miles away over the veldt before we wake up. i now have charge of a medical line of tents, and find the work very interesting, though there are many difficulties to contend with. the boers seem very thick in the country round; they have captured a train with horses between here and h., and the other day they took head of cattle from a loyal farmer only about six miles from here, and he had to fly for protection. some dragoons, who have been scouring the country for some weeks, were through here the other day, and one of their poor horses fell, exhausted, near to my tent; after a rest they got him up and went on, but soon a sergeant returned to say that he had fallen again, and they were going to shoot him, could he borrow some mules and tackle to pull his body off the path? i said, "oh, don't shoot him--i badly want a horse, and i'll get him some gruel and brandy from the store." he said i might have him if i would look after him, or else get him shot; but when we went out we found the men had already shot the poor beast. there are so many dead horses, mules, and oxen about that it is rather horrid walking anywhere beyond the camp, and sometimes we hear that the boers have put a dead mule (and once we heard some dead kaffirs) into our water supply, and it makes us rather squeamish, as we can't even get our drinking water boiled here. some of the officer patients tell us that they have drunk nothing but boiled water all through the campaign until they came here, and now they can't get it boiled for them. i am beginning to get papers from home, and they are much appreciated by the men, especially the six numbers of the _daily mail_ that come each week; i take one to each of my tents, and then they exchange them about. of course they are a month old, but, for all that, they are the latest news, and heaps of men from other lines congregate to hear them read. after much trouble i have retrieved that box of cushions sent by the queen, and they are treasures indeed; nice big feather cushions covered in red twill, and labelled "a present from the princess of wales." it was a little difficult to know to whom to give them, as, of course, all the men wanted one. i am trying to give them to invalids who will go home when well enough, as they will be very useful on the voyage, and the men could hardly carry them with them on trek. we had much excitement here early this month: one morning we were awakened at a.m. by the sound of big guns, and in the course of time we heard that the boers had blown up some culverts in the night, and captured a provision train; then there was a heliograph message to say, "heavy fighting since daybreak," and they wanted some medical officers; so two men went off with ambulances, but it seems none of our men were wounded; five or six boers were killed, and two of their wounded were brought here: one poor chap with a shell wound of the head is not likely to live; he looked just a rough country boy in corduroys, but he has "f. j. joubert" marked on a handkerchief, so he may be some relation of the general. the guard of the train had a rough time, as they took away his boots, and then made him carry sacks of provisions for them up a steep kopje. for the present, they have stopped the trains from running at night. i do think the railway men have been awfully plucky in sticking to their work, when they could never feel confident that the line was not mined. we had orders not to go outside the camp for some days, and the c.o. went round and took notes of all the men who were fit to take a rifle if there was an attack; and of course all the men ride about armed. we had a quiet easter day here. the sisters were expecting some officers of the th dragoons over to tea, but they did not turn up, as they had been out all night chasing boers. a few days later the boers burnt a hotel and stores at ingogo, and some troops were hurried through here to go after them, but of course they got away. still a great many deaths here; the other day we had four in twenty four hours; one of those who died was a doctor whom i knew slightly (he travelled up the coast with us when we first came out). he had been practising out here, so his wife was able to come and be with him, and she stayed in our camp. the poor man had heart disease. of course he wasn't in my line, but the sister of the officers' ward had a case in the theatre, and as he had been asking for me the lady superintendent asked me if i would go to sit with him if i could leave my line for a bit. i managed to be with him most of the day, and he died in the evening, and i went with his wife to the funeral the next day. the enteric line is now full, so one of my tents has been allowed to have night orderlies, and we collect the bad cases into that. you would be amused at a "kit inspection" here: when one is proclaimed, the excitement is great, and the orderlies, almost tearing their hair, are so distracted that if the sister has any bad cases, she must nurse them herself, or understand that they will get no attention till the inspection is over! all the ward equipment, mugs, plates, buckets, brooms, &c., has to be laid out at the tent door for the officers to count. in a hospital at home, when "stock-taking" comes, you know that anything that is worn out, or damaged, or really lost, will be replaced, and you are glad of the chance of getting things made correct; but here they assure me that things must _be_ correct, or the orderly gets fined or punished; so, to avoid this, he resorts to strategy. as soon as the officer (with the wardmaster and orderly in attendance) has passed one tent as correct, the things may be put away again, and then comes in the help of the patients (who fully enter into the game), the most nimble trotting off with a medicine glass to one orderly who is short of that, or a bucket to another; i have known a good broom do duty for three different lines by careful dodging about. i find one of the senior sisters here is one who applied to me when i was choosing sisters to bring out at first; but i had many to choose from, and i made no mistake in thinking others more suited for the work! another sister who _did_ come out with me has recently come up here, but she has not been very well since she came, and thinks the life here is very rough, so she is trying to get an exchange. sisters can get away from here only by inducing others to exchange with them; and it is not easy to make any one believe that this is a desirable station. i have not tried yet, as i want to stick to it if i can (of course i can't do much, but i can make a few men more comfortable), but most of the others are trying to exchange. our meat chiefly consists of trek ox, and it is so tough that it is difficult to tackle; about once a week we get skinny mutton. the bread is all right, but several times lately the butter has not arrived, and we have to do without. we buy chocolates and biscuits at the coolie store to fill up the cracks. the other day we had in a sick convoy that had been seven days on the road, and one poor fellow was so bad with dysentery that he died an hour after they lifted him out of the ambulance; really these long days of knocking about in the ambulances seem about the worst of the hardships that the poor chaps have to put up with, especially for the very sick or the wounded. you see, most of the waggons are drawn by about sixteen mules, and sometimes they trot and sometimes they walk, but sometimes they turn really mulish and won't budge; and then, after much hauling and thrashing and shouting, they start with a great bound and go off at a gallop. they are seldom on anything that you could call a road, and are much more frequently on the rough veldt. a man who has been badly wounded can tell you all about the day when he got knocked over--he does not care to say much about the long day in the blazing sun, when he lay thirsty where he fell before the bearer company came along; and then, perhaps, the dark night with frost on the ground, or rain falling; he shudders when he tells you of the groaning men who lay around him, and who gradually ceased to groan, and how he began to think the ambulance would be too late to pick him up too--but what he simply can't bear to speak about is the agony of being pitched about with a fractured bone for days in one of those waggons. it is not so bad when the fighting is anywhere near the rail, as then the wounded are soon placed in the hospital trains, and are fairly comfortable; but the long days of travelling by waggon are terrible. general dartnell's column was through here the other day, and they have gone into camp about two miles from us for ten days' rest. he has about men with him, and they have about filled us up with sick, while a good many went straight on board a hospital train. major ----, of the commander-in-chief's bodyguard, was with this column, and came over to see me; his wife was in cape town when i was last there, and went home on the _canada_. you know how particular he is about his horses, &c., at home? he drove over to see me in a very ramshackle old cape cart with a big horse running as a pair with a rough little boer pony. his uniform was in rags, and we did a little stitching up for him before he returned; they are having a very rough time of it. xlv general hospital, natal, _may _. there have been some big ructions here lately, but i think, perhaps, they may have done good in some ways. i don't think that i told you of a difficulty with which i had to wrestle when i was on night duty, and which bothered me a good deal. i believe it is a general rule in the army nursing service that the sisters give all the medicines and stimulants; and, of course, i expected to do the same here, but when i got to the enteric line on night duty, i found that the day sister left them all to the orderlies to give in the daytime, and the night orderlies gave them in the night. generally there were good orderlies there, who were quite to be trusted, but every now and then there were odd men on, and of course i could not be sure that the stimulants, &c., were correctly given. the day sister gave me no report of what the men were on, but it was given to the orderly. i did not quite know what to do, but i went to the lady superintendent (after seeing the sister of the enteric line) and told her that if i was to be responsible that they were given, would she arrange that i was given the report, as otherwise i could not tell that everything was given as directed; but if it was right to leave it in the hands of the orderlies i would _try_ to see that it was all right, but would not be responsible if anything went wrong. she seemed to think the day sister would not have time to give all herself (she had charge of only the one line, whereas the night sisters each had five or six lines). anyhow, she did not do anything at all in the matter, so i just muddled on as best i could, and used always to try to be around when important medicines were due, so that i don't _think_ much was neglected. then, last month, another night sister was on, who did not get on well with the orderlies, and she reported one of them for being asleep, and he promptly replied by reporting her for not doing her duty and giving the medicines, &c., so that he had to do it all. then came the ructions, and now the sisters have to give everything, and i believe they are going to put on a third night sister, so i think things will go more smoothly in time. the lady superintendent has only once been round my line since i have had charge of it. i had a curious case the other day that gave us a good deal of anxiety--that of a young lance-corporal, who had been bad with malaria, but was better and able to sit up in bed. i left him one night very cheery and bright, and the next morning i happened to meet the night sister as she went off duty, and she said, "oh, sister, i forgot to report that that lance-corporal of yours in tent did not seem so well, and he was sick this morning." i thought that i would go and look at him first instead of beginning my round in tent , and i was shocked to find the poor boy quite unconscious, and almost pulseless. of course i sent for the doctor and got brandy, hot bottles, &c.; the doctor thought it was all up, but he injected strychnine; he said he thought it must have been typhoid and not malaria, and that this meant perforation. anyhow, the boy began to revive; i hardly left him all day, but now i think i may say he is out of danger; i really think it was heart trouble, perhaps embolism, but i have seldom seen a man pull round after being as nearly gone as he was. of course you will have heard that the poor old _tantallon castle_, the ship on which we first came out, has gone down on robben island. the passengers and the mails were saved, and i was rejoiced when a nice, soft little blanket arrived that my people had sent out by her; i roll myself in it inside my sheets, and am much more comfortable. it is a curious thing that so many ships in which i have travelled have gone to the bottom: i made one trip years ago up the coast on the _drummond castle_, and went down the coast on the _courland castle_; i also went home from tenerife on the _fez_--they have all gone down, and now the _tantallon castle_ has shared their fate. there was a big dance one night about three miles from here, to which twelve of the sisters went, and another night there were some theatricals. i daresay i am wrong, but somehow these festivities seem a little out of place while the war is still going on. some of the sisters appear to think that they have come out here to have as much fun as they can get, and they talk about very little except the men they have been dancing with, and so on. the wind has been tremendous lately, and four of the patients' tents have been blown to ribbons; we seem to spend most of our time on duty trying to keep the men's tents up (with not more of the gale than is absolutely necessary blowing round the bad cases), and most of our time off duty in attending to our own tent-pegs, &c. of course wind here always means dust, and sometimes it seems as though the stones fly up and hit you in the face, and unless one takes great care the patients' milk is soon full of sand. really, if it was not that the men suffered for them, some of our difficulties would be amusing. when this hospital was a "field stationary" all the men had warm, grey flannel shirts; when it became a "general" they were given instead white cotton shirts and white flannel vests. that was all right at first, but recently the hospital has been enlarged, and, though there are plenty of the cotton shirts, they have run out of the flannel vests. now the winter has begun, and we have many men in with rheumatism and chest complaints, and the tents are very cold, but the poor chaps are only given cotton shirts. i know there are plenty of the old "greybacks" in the store, but because this is now called a general hospital they are not correct, and so cannot be issued, and the men must wait till more vests arrive! we have all fussed about it as much as we could, and we bought flannel shirts at the store for our worst cases (a man is always most grateful for an extra shirt to take with him when he goes away, so they won't be wasted), and now, at last, the old greybacks have been dealt out. at last they have got some boilers on wheels, so that we can get hot water in the tents; but _why_ should we have to wrestle so long to get things that make so much difference to the health and the comfort of the men? the lady superintendent is always saying that she does not know how we should have done in ladysmith; but we all reply that we should have tried to make shift, but we can't see why we should have to "make shift" here quite so much, with an open line to the base. i do wonder when the war will be over: the poor tommies are so heartily sick of it, and are beginning to try every means to get sent home; you see most of the excitement of war has pretty well worn off, and now they just have to keep on trekking about the country, destroying farms, and bringing in boer women and children to the refugee camps. they generally collect more destitute people on the way than they reckoned for, and, as they have to feed them, the rations for the troops run short, and the men are cut down to half rations (and sometimes quarter rations); and some columns out this way have had nothing but "mealie meal" (indian corn), and not too much of that, for some days before they got into camp. sometimes they have been on such short rations that men have had to be punished for stealing their horses' rations of mealie meal. when they pass through a village, the first place they make for is the baker's shop, and it is very soon cleared, and you see the men going on with loaves slung around them, and rather in the way of their rifles. when you consider that they are generally marching all day in a hot sun, and that in summer the nights are often wet, and in winter they are generally frosty, and the men just have to lie down hungry on their mackintosh sheet (no tents), with their greatcoat and sometimes one blanket; that they hardly ever have a chance of shooting at a boer, but are constantly being sniped at during the nights--is it any wonder that they are utterly weary of it all? we have not heard so much about boers being close around here since general dartnell's column went through, and now the sisters are generally allowed to ride again. our tent is the last one at this end of the camp, and when we were told that we were not to go more than a mile from the camp in any direction (except along the line) it used to be strange to walk out, after we came off duty, for a few hundred yards beyond my tent, and then sit down on a grassy ridge as it got dark and watch the heliographs flashing around, and wonder whether the little lights we saw meant our men or boers camping out. sometimes we used to imagine they were quite close and watching us, and used to go back to our tents feeling quite creepy, and borrowing an extra piece of string to tie up our tent door! and then, when we heard the guns in the distance, it was always a debatable point whether it was worth getting up and dressing in case any wounded were brought in soon, but we generally decided to finish our usual allowance of hours in bed. people are kindly sending me english papers now, both from england and passed on from durban, and they are very much enjoyed; the men were especially delighted last week when they got hold of an old weekly edition of _the times_ in which general buller and general roberts mentioned some of the regiments to which they belonged. it is getting frightfully cold at nights; there are big icicles hanging round the water tanks, and when one of them overflowed there was quite a little sea of ice round it; the water in our tents often freezes, and it is quite difficult to break it to wash in the morning. the night sisters are very miserable with the cold; i shall have to take my turn on night again next month, and i shall be quite sorry to give up my line, as the patients are so awfully grateful for what one can do for them, and i have nice orderlies just now. we go to bed directly we finish dinner at night, so as to try to get warm. xlvi general hospital, natal, _june _. thank goodness the winter will soon be over. i have never felt anything like the keenness of the cold up here. on the whole, things have been fairly quiet in the country round just lately, though once the line was threatened and some of the trains delayed; and on another day there was a rumour of fighting not far off, and it was said that we had lost some guns, but i don't think there was much truth in the report. things are also going a little better in the hospital. we have a new lady superintendent, the other having gone home on a hospital ship. there has been another big dance, to which most of the sisters went, and some other entertainments. one night we (my tent full) had all gone to bed to try to get warm, when some one came banging on the canvas, and sister ---- of the hospital train put her head in; you know she was an old london friend of mine. her train was tied up here for the night, and, as she had heard our men were suffering from the cold, she had brought up a noble present of flannel jackets for them. they really were treasures: of course, i wanted them all for my own line, but had to be generous and give up a few to sisters who really had some bad chest and rheumatism patients. talking about rheumatism--i had one man in with rheumatism who was rather bad at first; he would not improve, but remained so helpless that the orderly had to lift him about. i did not quite know what to do with him, and began to think that if an r.a.m.c. surgeon had been on my line the improvement would have been rather more rapid than with the civil surgeon who had charge! then, one day, i had a man bad in the next tent to this man, so i asked leave to go down to do something for him one evening after we had gone off duty, as i knew the night sister would be too busy to go to him when she first went on--and here there is always an hour's interval after the day sisters leave the camp and before the night sisters go down. what was my surprise when i got to the tent to find my rheumatic patient in there playing cards! he had pretended he could not sit up in bed. i only said to him that i thought it was time he turned in for the night; and the next day i handed his board to the medical officer when he came round, and said that if he did not mind marking him "up," i thought it would do him good to sit out in the sun in the middle of the day, if the orderly put him to bed after tea. you can imagine the poor man felt pretty small, and in a few days he told the civil surgeon that he thought he felt fit to go back to duty, so we shook hands and parted good friends. i hope that he will not get shot, or i shall wish i had let him slack a bit longer! we have had a good many boer patients in lately; one poor young captain has lost his leg. one old fellow used to crawl about on crutches, but he was caught one night slipping about without them, and a boer woman was found outside the fence with his clothes; so now all the boers have been collected together and a guard posted. i am now on night duty again, and find the orderlies more attentive, and the patients (generally) better nursed. the first night i was on duty i was just reading the reports and trying to find out where the worst cases were, so as to visit them first (i now have beds on my side, instead of the i had when i was on before), when a wardmaster came to tell me that a sick convoy had turned up unexpectedly from general bullock's column, and one man had been wounded on the way and had some hæmorrhage from a shattered hand. i helped the surgical sister get the theatre ready in a hurry, and then she stayed for the operation, while i went to see the others. there were only fifteen men, and they were black as sweeps and very cold; but they did not seem very bad, and they were delighted to be in shelter, with the prospect of a bed. the orderly officer asked me to give them anything i liked, and he would order it afterwards, while he went to the theatre with the case; the wardmaster got them all some bovril, and we soon settled which of them might have bread with it; and then i had not the heart to insist on the usual wash, as it was so bitterly cold, but i let them all tumble into beds, and then took round a bottle of whisky and a kettle and gave them all a hot drink; there was nothing more heard of that lot of men (but snores) for a good many hours! poor chaps, they were absolutely tired out, and the medical officer quite approved, only saying he thought they might have had two bottles of whisky amongst them instead of one, but you know i am a strict teetotaller! having settled them, i started my rounds, and soon found that the worst case was a poor chap with pneumonia; fortunately he was in a building (instead of a tent), so it was possible to keep him fairly warm. the night orderly was not a very intelligent youth, but he was fairly watchful and obedient, and for four nights i spent every spare minute with this man, and really thought we should pull him through; then the fifth night the day sister met me in a very bad temper, and said, "what _do_ you think? they have moved our poor o. down to a very draughty enteric tent; after all the trouble we have taken to pull him round! i am sure he will die there." i asked why he had been moved, as there had been no sign of enteric, and she replied that she could not get any reason, but an orderly had told her that "the doctor said that he was going to die, and he did not want any death up there." poor chap, he did die the next day, and of course he _might_ have done so in any case, but to shift him then just took away his only chance. it has been very cold all the time that i have been on night duty, but two of the nights were so horrible that i don't think i shall ever forget them. sister ---- is on with me now, so we grumble together; for those two nights it was blowing _hard_, and then a sleety rain came on that positively cut like knives, and was almost paralysing; on the second of those two nights i struggled back to the duty room and flopped down by the fire, which was very low, but i had not even the energy to poke it up; after a bit sister came in dripping wet and looking blue with cold; she set down her lantern, and then came to the fire and gazed at me, and, after a bit, said, "sister, you do look ill." i tried to laugh, but i think we were both much nearer crying with cold; so i struggled up to attend to the fire and brewed some tea, and after a bit sister said, "do you know, sister, when i came in i thought you looked as though you were going to die, and if you had been, i positively had not the power to set to work to get you a hot drink or anything." i told her i thought we were both too tough to die of cold, and then we both (feeling a little better for the tea and warmth) had to tramp off again to give brandy to some of the bad cases. after that, they put on another night sister, so the work was not quite so hard, and we could take rather longer spells in the duty room to get warm, but we have not had rain (as well as the cold) except on those two nights. last night was full of excitement: during the day a poor young australian lad had gone off his head and had been put in a guard tent, and he tried to get hold of the sentry's bayonet. then there was much commotion because the c.o. found one of the signalmen was drunk, and brought him down to the guard tent. then sister ---- found an orderly straying about, who was supposed to be special with a young r.a.m.c. lieutenant who is down with fever, and the orderly did not seem to know what he wanted; so sister flew off to the tent, and found the lieutenant very much upset, and saying that the orderly was quite mad, and had refused to go and fetch the wardmaster when he ordered him to do so; he said he could not tell sister what mad things the orderly had been doing; so she had to send for the medical officer, who got the orderly removed at once and another posted. there is not nearly so much drinking as there was at first, but still they do find ways of getting drunk at times. a little while ago there was a great row because the convalescent officers were allowed to drive or ride about, and they used to go over to the next town and bring back whisky and champagne. i don't think there was much harm in it at first (except that it was a bad example for the men), and it was winked at for some time, until they had a very rowdy lot of men in, and then one day one of them was found to be suffering from d.t. i am glad i am not lady superintendent up here: i should find it hard to know where to draw the line with the present lot of sisters; at first they were given every liberty, and were rather encouraged to go to dances and riding picnics, &c., with the men; then, when their behaviour began to be talked about, the authorities put up notices in our mess-room of rules referring to conduct of which no lady would be guilty, rules which were, in fact, an insult to us, but which we cannot say are unnecessary, because there are just a few sisters who don't care what they do--one of them was seen at a hotel at the next station smoking cigarettes with a most undesirable companion! we can only hope the war will soon be over, and let us all go home; otherwise, the sooner sisters of that sort are weeded out the better. they seem to have been choosing the sisters in a very casual way at home lately, and, though there are plenty of sisters out here who are working hard and well, they will probably all get classed together in the public estimation with those who are simply "frivolling" and getting themselves talked about. xlvii uitenhage, cape colony, _october _. it is a long time since i have written to you, but for some time things went jogging on very much the same as when i wrote last, and there was little to write about, and then lately i have had a wretched time of it, so did not feel inclined for writing. after i finished my turn on night duty i went back to my line, but soon knocked up, and was ill and off duty for nearly three weeks; first with dysentery, and then my damaged side got bad again. by the time i got to work once more, the weather had very much improved, and my tents were very light. i received from home some splendid boxes of literature, and also of tobacco and jerseys, and some games for the men. i taught them to play halma, and it was very popular; they used to make out it was a competition between the different branches of the service--the greens were always the volunteers, the yellows were the yeomanry, the reds the regulars, and the blues the navy or the colonials; sometimes they could get a representative of each branch to play the men, and then there was much excitement as to which would get in first. the men in my line got a photographer to photograph them, and presented me with a large copy. you can understand that we were fairly slack when i tell you that we used to brew toffee in the duty room on afternoon duty. i think we were all very tired of ration feeding, and we were all getting thin, and when one gets to that stage one has a sort of craving for sweet things, so the toffee was very popular. something went wrong with the washing arrangements for a time, and we could not get our things washed, so for a week or two we had to wash for ourselves, and, irons being very scarce, we had to press our things by putting them under our mattresses and sleeping on them! a column camped for a night near to us, and sent us in some sick, including a good many cases of measles, that had to be sent to an isolation camp. they had no sisters out there, and it was pretty rough and very dull; but the provision cart went out every day, so i was often able to send them parcels of papers, &c. early in september the town guard were all under arms, as there was some looting of stock quite near to us; and there were many rumours that we were going to be attacked (for the sake of the rifles and ammunition that the patients had brought in). the rifles, &c., were therefore sent to the next station. after that there was more fighting down at dundee, and then the natal volunteers were ordered out again. all this time i was very seedy, and trying to exchange to another station; but several of us had rather good reason to believe that, so many sisters having sent in for an exchange, their applications were never forwarded to the p.m.o.! then they had a "court of inquiry" at the hospital, and i was obliged to give some evidence: and it was simply horrid having to do so. after that i felt so bad i wrote to the p.m.o. direct to say that as i could not get an exchange, might i be allowed to resign? as my brother was just now in natal, and i proposed to go to stay with him, before going to england. at last i obtained leave of absence, and later on obtained leave to resign. _very_ much to my surprise, about this time, i learnt that i had been "mentioned in despatches," and, a little later on, that i had been awarded the royal red cross; i am sure i have not done anything to earn it, nor have i done as much as many of the others; but, of course, it is very nice all the same. i had such an awfully kind letter of farewell from the men of my line before i left, thanking me for what i had done for them. we had a good many "gentlemen troopers" in, the last part of my time, and some exceedingly nice fellows amongst them. one, who was especially helpful, had been an officer on one of the big liners that came out here, before the war. he is now a gunner on one of the armoured trains, and has had a very exciting time of it. my brother was in durban, so i left one morning at a.m. to join him; i put myself to bed in the train the night before, but i was prevented from sleeping by the shunting of engines and by the letting off of steam, &c. i was the only lady on the train till we had got some way down the line. we were delayed for an hour soon after we had started, as there had been a bad collision the day before, and as the telegraph line was damaged they had to give us a pilot engine. it was a very rough line, and the train swayed about so tremendously that i was feeling quite sea-sick; then, when we were rattling down a steep hill, there was a sudden explosion, which, of course, made us think of boers and many things, and we pulled up with such terrific jerks that we and our baggage all became mixed up on the floor. as soon as we could disentangle ourselves, we looked out--quite expecting to see a party of boers--but only saw one man waving his arms violently, and we came to a standstill just as we rounded a sharp curve, and found ourselves immediately on the tail of a heavy coal train that had got stuck on our line; the explosion was a fog signal they had laid to stop us, and it saved us from coming a very nasty cropper down a steep bank. i had told my brother i should spend the night with friends at pinetown and join him in durban the next day; but when i was leaving i had a wire from him to say i had better come straight down, as he might have to sail the next day, so, _en route_, i wired to my friends not to expect me. i had a very early breakfast at glencoe (and the usual wash at a tap on the platform!), and we were so late in reaching estcourt, where we were supposed to lunch, that by that time i had a really bad headache, and could only rise to a cup of tea and a roll. inchanga is the place where one always dines, whether going up or down, and we were due there about p.m., but about . p.m. we got stuck in a siding about a mile from inchanga; and there we had to remain nearly an hour because lord milner was dining at inchanga, and we had to wait till he had passed; we did not bless him for taking so long over his dinner while we starved! by this time i was feeling really ill, and thought it might be partly from want of food, so i made myself eat some soup and a little chicken; then i was establishing myself in the train again (thankful to think that it was a "no stop" run to durban), when another wire was thrust into my hand from my brother saying, "no beds, if possible sleep pinetown; not leaving till following day." i groaned, but bundled out again, with my kit-bag open, and my rugs, pillow, books, &c., all loose, just as the train departed. i thrust my goods into the hands of an astonished little kaffir boy, who helped me to pack up my kit-bag, and of course i had to leave my heavy baggage to take care of itself. i did not have to wait long for the "kaffir mail," which _does_ stop at pinetown, but i knew my friends would all have gone to bed as they were not expecting me, and of course no one would meet the train, and their house was some way from the station, and it was raining steadily! so i felt pretty miserable. i was put in a carriage by myself, and after we had started found there was no light in it, and i felt really ill, and wished i had not made myself eat any dinner! however, just as we ran into pinetown i looked out, and some one hailed me, and there was one of my best old pinetown orderlies (now working on the line). he seemed so pleased to see me that i felt inclined to embrace him, but refrained! as soon as he had seen the train off and had locked up the station, he shouldered my bag and escorted me to my friend's house. they were all fast asleep, but soon let me in, and i don't know when i have been so thankful to turn into a comfortable bed as i was that night. it was a little over eight months since i had slept in a house. the next morning they brought me a delicious breakfast in bed--hot scones, &c.; you don't know what it was like after camp feeding, to have a pretty tray with a cloth on it, and everything dainty and nice; and i was very loth to leave both my bed and my kind friends; but about mid-day i again boarded the train for durban, retrieved my baggage at the station, and then found my brother at the marine hotel. i had time to see a few friends and do a little very necessary shopping, and then we went on board the _arundel castle_ to go down the coast to port elizabeth. you can't think how funny it was to walk upstairs again: the pinetown house was a bungalow, so i did not have to try stairs till i got on board ship. i still feel as though i must duck my head every time i go through a door, and when it blows in the night i always wake up and wonder whether i ought to take the mallet and attend to the tent-pegs; and then, when i realise i am not under canvas, there is such a satisfaction in being able to lie down and go to sleep again. we did not stay in port elizabeth, but travelled by train straight on here, where my brother has about three days' work. we have a very comfortable little house to ourselves, with a garden full of such lovely flowers--maréchal niel roses, &c. this is a pretty little town, and many of the people, who are most pleasant and friendly, have called on me. near to uitenhage there are still some wild elephants, but i had not time to make their acquaintance. to-day the minister of the dutch reformed church took us to see the riebeck girls' college; such good buildings, and such bright-looking scholars. they have a kindergarten, and then all the standards up to the highest--those working for university exams. the resident magistrate took us to see some nursery gardens that send flowers all over south africa. after the barrenness of the natal uplands these masses of flowers were quite lovely, and i was given a beautiful bunch of carnations. to-night we have some people dining with us, and to-morrow we return to port elizabeth, where we shall probably stay about ten days. xlviii kimberley, south africa, _december _. from uitenhage we returned to port elizabeth, where my brother had about a week's work, and then we had to wait a few more days for a steamer; but several old kimberley friends were down there, and a good many other people called, so i had a very pleasant time. port elizabeth was a little agitated about the plague; they had had about a hundred cases, and about half of that number had died, but just then there were only twelve in the hospital. one day i went out with three ladies to a place they call the red house, and had a delightful row up the zwartkops river. another day mrs. ---- drove my brother and me out to her father's country house, "kraggakama," about a fourteen mile drive; a beautiful bungalow house, and such a lovely garden, surrounded by dense, semi-tropical woods, with little paths leading away into the woods; many monkeys and other creatures around. we had lunch out there, and found strawberries just ripe in the garden. from port elizabeth we had meant to go straight back to kimberley, but, after many wires, it was decided that my brother must go to oudtshoorn, a place a long way from the railway, where there had been cases waiting for a long time for trial, as it had not been considered safe for a judge to travel there. to reach oudtshoorn it was necessary to go by steamer to mossel bay, and the mail steamers, as a rule, do not call at mossel bay. moreover, port elizabeth being an infected port (with plague), the mail steamers were not keen on taking passengers from there; so there were many obstacles to be overcome. i packed up my heavy baggage and sent it up to kimberley; then the _norman_ was signalled, and we went down to the jetty, and had to be examined by the medical officer of health for plague symptoms! and then the harbour-master took us off in a special tug. the next morning they put us ashore at mossel bay, and there we had to wait some hours as the commandant was very doubtful as to which was the safest route for us to take; there were still a good many boers in the surrounding country, and, though they probably would not wish to interfere with us, they would certainly be very pleased to annex our provision cart and also our horses and mules; and the c.o. had so weak a garrison that he could spare us only a small escort. after some time spent in wiring, it was decided we should drive to george and sleep there. the baggage and provisions were sent on with a mule cart, and, after an early lunch, we got away in two cape carts with four horses each. the distance was about thirty miles, and we outspanned only once--at brak river, where we had some tea, and there an escort of six cyclists met us from george, and the mossel bay men turned back. the cyclists were very smart fellows; some of them scouted ahead, and the others rode with us very steadily uphill and down. it was getting dark when we neared george, and the commandant and magistrate rode out to meet us, and then stayed and had dinner with us at the hotel. george is a pretty place, with streets lined with fine old oaks, and with big arum lilies growing in the fields around. just in front of the hotel there was a stout little sandbag fort with a small gun, and, of course, there was very strict "martial law" there; pickets on every road, and no one could leave the village or come in without a permit, and even with a permit you must be within the picket lines by sundown. no one might be outside his house after p.m., and lights must be all out by p.m. we were to sleep at george, and the commandant told us that he had already sent out a patrol of men, who were to sleep at the top of the montague pass, and meet us there the next morning; he wished us to slip away quietly in the early morning, and his patrol would soon join us, and ride with us till we met the troop that was being sent out from oudtshoorn to meet us. the commandant has about men under him. they are nearly all local men, in fact many of them boers, but he was quite confident of their loyalty, and said the poor chaps were suffering badly for it, the rebels burning their farms and doing them all the harm they possibly could. just when we were there he was very sad because one of his scouts, quite a young lad belonging to george (and very popular in the place), had been most cruelly shot by them after he had had to surrender. the next day we started in our carts about . a.m., every one seeming to think it would be a risky drive. after we had gone some way our driver began to pull up and looked scared (he could speak only dutch), and we made out that he could see some horses off-saddled higher up the mountain, and he thought it was boers waiting for us. with some difficulty we explained to him that we expected the george escort to meet us at the beginning of the pass, and then he agreed to go on; but we were all somewhat relieved when we got up to the horses and found they belonged to genuine district mounted troops, and that they had not seen any boers about. that day we travelled between forty and fifty miles, through beautiful mountain scenery, which reminded us of switzerland (minus the snow); lovely ferns and cool, dripping water, and quite high mountains all round. we outspanned only once for a breakfast-lunch at doom river about a.m.; scheeper's commando had honoured them with a visit there, for looting purposes, just before he was caught. at hymen's house, about mid-day, we were met by a captain and twenty-two men from oudtshoorn, and the george men went back. we got safely into oudtshoorn about p.m., and expected to be there about three or four days, but the work was heavier than had been expected, and we were there a whole fortnight. this was rather fortunate for me, as i knocked up with a very sharp touch of dysentery again, and should not have been fit to travel much sooner. the oudtshoorn people were extremely kind, and, when i got better, i had some charming drives to visit farms and other places of interest. it is a rich farming district, and it was the first time i had seen anything of ostrich farming and tobacco growing; so i found a great deal to interest me; they also grow grapes and other fruits, and it is a good corn-growing country. the ostriches do especially well all along the course of the oliphant's river. i got some good photos of the ungainly creatures. martial law was very strict, and (besides the same rules as those which i told you were in force at george) the farmers were not allowed to keep any horses or food supplies on their farms in case the boers should take a fancy to them;--all horses had to be sold to the remount department at a fixed price, and farmers and other residents in the district, who were accustomed to keeping plenty of good horses, might be seen coming into town with oxen in their traps; and as they were not allowed to keep more than a week's supply of food or forage on their farms, and as some lived many miles away, they had to spend a good part of their time on the road in drawing their rations, as, of course, the oxen are very slow travellers. they were reaping the corn when we were there, and it all had to be carted into town and sold to the military people, as they cut it. oudtshoorn, being far from the railway, had been very short of provisions (groceries, &c.) for some time past, and the military authorities would not allow any waggons to go up from the coast without a strong escort (which could not often be spared); but a convoy had been sent through before we got there, so there was plenty of food, and our provision cart had a few luxuries which seemed to be appreciated at the two dinner parties we gave. from oudtshoorn we still had more than a day's journey to join the railway at prince albert road, and horses were so scarce that it was not easy to get decent animals. we sent the baggage cart (with mules) on ahead, and, eventually, my brother and i (and our man) got away in a light cape cart with two fairly good horses, and the other men had four screws in a bigger cart. the scenery, as we crossed the zwartberg, was very _grand_, but not quite so _pretty_ as the montague pass. it was very stiff work for the horses, and we walked a good deal. our first outspan was near the cango caves, where they had recently had a visit from a boer commando; and then we had to give the horses a good rest at the "victoria hotel," high up on the zwartberg. we were rather disturbed to find, when we caught up our baggage cart, that it had no brake on it: the road is tremendously steep, as it zigzags down the mountain; so the sergeant in charge of our escort left a trooper to help the boy bring the mules down. we got in about p.m., but there was no sign of the baggage cart that night, and the commandant (who had ridden out to meet us and then dined with us) was anxious, because only one trooper had been left with it, so he sent some more men out to meet them. we had to go to bed without our baggage, feeling very anxious, as every one seemed to think the boers would much like to get hold of it, and also of the mules. i have seen plenty of barbed wire in south africa, but have never seen so much as at prince albert; they stretch it even across the village street at night, and you can't go many yards without getting tied up in it. the next morning, if we were to catch our train (and there was only the one train a day), we knew we must be away by . a.m.; but still no sign of our baggage; and then, at last, we heard that it was safe, but the crossbar of the harness had broken, and they had had to spend the night on the top of the mountain; a trooper had ridden in and gone back with new harness; so, after sitting at our gate with the commandant, with a fresh supply of carts, and a fresh escort, until it was too late for it to be _possible_ for us to catch our train, we had to decide to wait till the next day, and various wires had to be despatched about the railway carriage, &c. about two hours later the missing baggage-cart arrived all well, with a very weary driver and troopers in attendance. we had a pleasant day at prince albert, and the next day (having sent the baggage on at an early hour) we had an easy drive of twenty-eight miles with some excellent horses (most kindly lent to us by the commandant), to the rail at prince albert road. we outspanned only once, at boter's kraal, where the final escort met us, the sergeant coming up to salute and to tell us that he and his men "had searched the kopjes thoroughly since a.m., and had seen no boers to-day!" but at boter's kraal they told us of a recent visit from pyper's commando. thus ended our (odd) miles of driving across the colony in this "sort of a war," without once having had the excitement of seeing any armed or hostile boers. about thirty hours in a hot and dusty train brought us into kimberley. the dull old karroo country looked much the same as when i saw it ten years ago, except that every few hundred yards on the line a blockhouse is standing, and a sentry in his shirtsleeves marches up and down with his rifle, while the rest of the garrison (some half-dozen men) come to look at the train, and to sing out "papers." they have a terribly monotonous life, and one throws them every scrap of literature one possesses. xlix kimberley, south africa, _january _. i think it is just about ten years since i was here last; and _how_ the place has changed! many of my old friends have left, and so many have died that i am beginning to be almost afraid to ask after any one in case i should hear of his death. of course they have been through all the horrors of a four months' siege, and there are still many marks of the boer shells to be seen; one of them had made a hole through our backyard wall and buried itself in the kitchen wall: peter (the cat) found this hole very convenient when going out to visit his friends. many people still preserved the bombproof shelters or "dug-outs" in their gardens, where they used to take refuge when the shelling was going on, and then go back into their houses at night to cook the food, &c. there is a big steam hooter at de beers mine, and, during the siege, whenever the lookout men saw the boers preparing to shell the town, the hooter was sounded, and every one scuttled into shelter; and even now, whenever the hooter sounds, people start up and look inclined to run. the civilians here cannot say enough for the way mr. cecil rhodes worked during the siege; and his thoughtfulness and consideration for the women and children were beyond all praise. at one time he had many hundreds of them in safety down one of the mines, feet below the surface, and he took infinite pains to send them down suitable supplies; they were in fairly airy chambers, and had a good supply of electric light, &c. of course the military people are not so enthusiastic about his assistance, but, naturally, they would not appreciate a man who always liked to have his own way, and do what he thought best--and who did it too! the first thing the boers did was to seize the waterworks, some miles from the town, and cut off the water supply; but the mine-owners came to the rescue by pumping water from a good spring in one of their mines that had caused them years of annoyance by rising and making the working of that mine a great difficulty; so the water question never caused them much trouble, though the boers were constantly trying to damage the pumping machinery. though the water supply was fair the food supplies were very low; and a rich family, whom i know, told me they were intensely grateful to a neighbour who sent them a quarter of a bottle of port wine and half a packet of cornflour as a christmas present. they were at that time drawing half their ration of meat in horseflesh, and, though some people say they could never touch it, i believe it was not at all bad, and one girl told me that a little donkey was "quite nice." a good story is told of a colonel who was then up here. one night at mess he said, "gentlemen, i am sorry to say we were only able to draw half our ration in beef to-day; this joint i am carving is beef, at the other end of the table the joint is horse: if any one would prefer to try it, perhaps he will carve for himself." no one got up, so the colonel had to carve (small helpings) for all the mess. after they had finished an orderly came and whispered to him, and he said, "oh, gentlemen, i am sorry to find i have made a mistake; i find this was the horse, and the cow is still at the other end of the table!" there was so much sickness in the town that the doctors had a terrible time. in most cases it was suitable food rather than medicine that was needed, especially amongst the little children; and, besides the sickness, there were a great many wounded constantly being brought in from the trenches, or from skirmishes, and every available building was turned into a hospital. i have just been reading dr. ashe's book, _besieged by the boers_, and it gives a good idea of the daily life up here, showing how men tried to go on and do their daily round of work in spite of the shells that were falling and killing not only men but women and children around them. the thing that kimberley people are most proud of is the big gun "long cecil," which was most cleverly designed and made in the de beers workshops during the siege, the shells for it also being cast there; until that was built they had _no_ guns of sufficient size to reply to the -pounder that the boers were using with so much effect upon the town. it must have been a huge surprise to them when long cecil began to scatter shells amongst them, each one inscribed, "with c. j. r.'s compliments!" the cemetery is sadly full of "siege" graves, and so many little children's graves amongst them. strangely enough one of the de beers engineers (an american) who was chiefly responsible for the building of "long cecil," was killed by a boer shell only a few days after the gun was completed; and, just as an example of how we were surrounded by enemies even inside the town, i will tell you about his funeral. in such a hot climate as south africa it is always necessary that the funeral should take place within about twenty-four hours of the death; so that it is quite possible to be talking to a man in his shop or at his business in the morning, for him to be taken suddenly ill and die that evening, and the next day, before you have heard of his illness, for you to meet his coffin on the way to the cemetery. well, this poor engineer was a very popular man, and the commandant thought that many people would wish to attend his funeral, so he gave directions that it should be at night, for safety from the boer shells. late in the evening, when it was quite dark, the funeral left the hospital; but it had no sooner started than a rocket was seen to go up _in_ the town, evidently a pre-arranged signal--for almost at once the boers began to drop shells around the cemetery, but fortunately no one was killed. perhaps you have heard in england of the little girl who knew so much about martial law that she strayed into the provost's office one day in december and said, "please, sir, may i have a permit for santa claus to come to our house!" all food seems to be frightfully expensive still: we have to pay about s. for a single fowl or duck, s. a dozen for eggs, and s. d. a pound for butter. we have a white woman as cook, and our black boy rejoices in the name of "moses." i had not been here many days before "george" came to see me--the boy i used to have ten years ago. it is extraordinary how these natives know when one returns, even years afterwards. of course george wanted to come back, but i found he was in a good place, so i told him i was soon going back to england, and i did not take him on. i have had two offers of rather good posts out here, but i think i must go home for a time at any-rate. there is a huge refugee camp just outside kimberley. i am afraid they have had an awful lot of measles in these camps, and there have been many deaths from it; measles were almost unknown on the scattered boer farms, and now that these people are crowded together in close quarters, with their traditional objection to fresh air or cleanliness, it seems impossible to make them take precautions against infection. as a rule, the people in the refugee camps have rations quite as good, and often much better, than the troops, but they do not thrive on them; still, it was impossible to leave them on the farms, for the only way to prevent the boers from keeping up their supplies was to take or destroy the crops, and, after that was done, it was impossible to leave the women and children on the farms to starve. now they are sending sisters to work in these camps, and they are doing all they can to help the people, but i fancy it must be rather uphill work, as many of the boer women are so very suspicious and bitter. i daresay you have heard of the woman who urged her husband to go and fight, saying, "i can get another husband, but i can't get another free state." i have had some interesting drives round the country with a lady who was here all through the siege, and could show me where the fighting had taken place; and one day some officers gave a very jolly picnic at a place called "the bend," about seventeen miles from here, on the vaal river. it was very hot weather just then, ° to ° in the shade, so we started at . a.m., and had breakfast and lunch out there. a mulecart loaded with provisions--delicious peaches and other fruits which had been sent up from cape town--had been despatched in charge of four orderlies (all armed). we rowed on the river and prowled about under the trees; and altogether it was quite the nicest picnic i have ever enjoyed. one of the officers of our party had the honour of being the youngest colonel in the british army; he has been promoted so rapidly during the war. they had all had a rough time of hardship, but they meant to enjoy themselves that day, and i think they did; but they kept their revolvers handy even when rowing up the river. i had been told that i was entitled to an "indulgence passage" home, as i have served during the war, and that would mean that i should have to pay only about £ for my mess on a trooper, instead of paying about £ for a passage on an ordinary mail-boat; so i went to the railway staff officer, and he was most kind in arranging about it for me, and (after communicating with cape town) he told me that if i would see the p.m.o. when i arrived down there, he would probably be glad if i would do duty for the voyage, and then i could travel quite free, and receive pay (instead of having to pay my mess bill). he also gave me a free railway pass down to the cape, which i had not at all expected. now, i must pay some farewell calls; and then, once more, i shall soon be on the move again. it really does seem as though the war will soon be over now. we hear that some troops are still coming out, but there appear to be more than enough sisters for the work that has to be done. l s.s. "orient" (_en route_ for home), _march _. i was very sorry to say good-bye to kimberley, but i was also getting very home-sick, so early one morning i once more joined the train, to stroll across the karroo and down to cape town. i had armed myself with a large stock of literature, kindly given to me by friends, and also by the librarian of the kimberley public library (who gave me a noble stock of back numbers), and this i distributed to the men at the blockhouses on the way. poor fellows, they have a trying time of it, they must be very wide awake and alert, or any night the boers may cross the section of line for which they are responsible, very likely leaving a little dynamite to wreck the next train; and yet for weeks and perhaps months never a boer may come near their particular section. the trains were still not supposed to travel at night, so we tied up about p.m. on the first day at de aar. after dinner i was just thinking it was very slow, not knowing any one in the place, and i thought i would go to bed, when i saw a general strolling along the platform, and with him a young officer whom i soon recognised as an old pinetown patient, and whom i was very glad to meet again. the general soon departed, and then captain ---- took me for a jolly moonlight walk round de aar; he was still a little lame from his wound, so was acting as adjutant for some yeomanry there. it was pleasant to hear about many other old friends, and also a little about the course of the war in that part of the country. the next day, as we proceeded down the line, we passed some troop trains going up with men who had just arrived fresh from england--i think some of the scots guards, the manchesters, and the lancashire fusiliers. some of them were tightly packed in open waggons, and appeared to think they were having a rough time already, but, as the weather was warm and dry, they were not so badly off. they seemed very glad of the few papers which i could give them, as they had seen none since they landed. their chief anxiety seemed to be as to whether they would have the chance of firing off a little ammunition before the war is over. that night we tied up at matjesfontein, and i much regretted i could not stay a day there to explore the battlefield; but i did not know which day they wanted me for duty, so i had to hasten on. the next morning i arrived in cape town; and, after a "wash and brush up," i went to see the p.m.o., who was most kind, and said that if i was willing to do light duty on the voyage, i certainly need not pay for a passage. if i was ready, he would like me to go on board the _orient_ on the th (it was then the th). i had a few very pleasant days with some friends at rondebosch; but i was unable to get about much to see other people, as i was again very seedy with dysentery, and had to doctor myself rather severely in order to get ready for duty on the th. i came on board that morning at a.m., but there was such a gale blowing that we did not get away till p.m. the next day. there are about thirty officers and between and men on board, almost all of them invalided home, and it is awfully sad to see so many "wrecks" of the war. the p.m.o. is a major of the r.a.m.c., and he is just as strict with the orderlies as the major i worked with at pinetown; so the men are well cared for, and i am enjoying working for him. i was the first sister to join the ship, and, as i found the cabins would be very full, i asked if i might act as night sister, and thereby i secured a cabin to myself. i have had plenty to do most of the way, as there have been several men and one officer very ill all the time; but we have had no deaths on the voyage, and most of the patients seem to be mending now. on my first night on duty i had been round the hospital, and then i thought i would take a look at the convalescent men in the swinging cots (ninety of them), and i found there a poor colour-sergeant, who had been out only a few months, going back with hopelessly bad heart disease from overstrain; he was unable to lie down, and so breathless and blue, i got him transferred to the hospital, and was able to make him comfortable with pillows, &c. he has been such a good patient and has improved a little, but i fear he can never work again, and he is a married man. there are two quite young lads who have been having epileptic fits frequently on the voyage--i suppose brought on by exposure to the south african sun. a young yorkshire farmer of the yeomanry was invalided home as a "phthisis" case, but he came into hospital the day after we sailed with a temperature of °, and he has been desperately ill with enteric all the way (severe hæmorrhage, &c.). he must have had fever for some time before it was diagnosed--the temperature being attributed to his chest condition. he is still very weak, but i think he will pull through. one night i was told that a man in the swinging cots was "rather peculiar," so i went down to see him first thing, and found his cot empty. i flew up on deck, and met some stewards, who had collared him on the upper deck. we made him snug in a safe corner of the hospital with a "special" for that night. then, there was one poor fellow who had lost an arm, and two who had each lost a leg--one of the latter a sergeant-major, who was wounded at the same time that colonel benson was killed at vlakfontein. he was a kimberley man, and the poor man's wife and two little children were all killed by one boer shell during the siege of kimberley. he is going home to get fitted up with a cork leg, and will then return to south africa. perhaps the saddest cases of all were the eleven lunatics we had on board. they had to be very safely kept with special guards and other precautions; and, in case they should try to go overboard, they had a high-railed enclosure on deck as an airing ground. some of them are very mad and violent, but some seemed so nearly sane that it was a question whether they had not pretended to be mad in order to be sent home. i was not supposed to visit these men in the night, because, to get to them, i should have had to go a long way through the troops' sleeping quarters, but the medical officer went to see them on his last round, and, every two or three hours, i used to stay in the hospital while the wardmaster went along, and brought word how they were. one night the medical officer went along, and when he returned he told me he had found their door unlocked and no guard on duty; fortunately they were all asleep. the next day this tale was about the ship, and very soon it was altered to the following version--"last night mr. ---- had found that all the lunatics had escaped; he and sister thought it better not to make a fuss. instead, they caught the first eleven men whom they met and locked them up; they were not the _real_ lunatics, but they had been bribed with extra 'skoff' to play the game and say nothing about it: but the real lunatics were still at large!" after that, if any one came up to a man rather quietly, there was a big jump, and "hullo! are you one of them?" and then a great chase round the deck! there were some hard cases, too, amongst the officers; two of them who had thighs broken by boer shells, but were just beginning to walk again--one, however, with a short leg, and the other with a stiff knee. a yeomanry officer, badly shot in both arms, had one hand still quite useless; but i hope an operation may improve matters. he had had a dreadful time in the jolting ambulance waggons, unable to hold on, or to save himself with either hand. then, there was a young doctor who once, when our men were surprised and many of them taken, was going round dressing the wounded, when some boers came up and shot the wounded as he was dressing them, and afterwards led him out several times saying they were going to shoot him, but eventually he got safely away. there were two officers shot through the lungs, but i think they will recover in time; and there was another young fellow shot in the region of the spine, and paralysed all down one side and leg; and yet another (quite a boy) shot in the thigh and paralysed on that side. neither of these two could move without assistance; and, though they were all wonderfully bright and cheerful, i know i often found them lying awake for hours together, and it is hard for a young englishman to face the thought that he may never be able to walk or ride again, even when he _has_ received his wound in defence of his country. as i finish this letter, we are just anchoring for the night in southampton water, off netley hospital; and, curiously enough, it is march rd, the very day i sailed for south africa two years ago. to-morrow we hope to land at southampton. after a little time at home, i hope to persuade a sister of mine to pay a visit with me to another brother in the united states, and to some relations in canada and nova scotia; then i must settle down to some steady work in england. i would not have missed nursing through this war for a great deal. we have often had rough times, and anxious times, and of course i have not been able to do much, but i have been able to help a few men to recover their health and strength; and, perhaps, also to help a few in their last hours, men whose own relations would have given much to have been in my place, where it was not possible for them to be. and, however busy i was, i could at least find time to remind them that ... "god shall wipe away all tears from their eyes; and there shall be no more death, neither sorrow, nor crying, neither shall there be any more _pain_."... still no one, who has not seen it, can realise the sorrow and the suffering that war entails; and i am _almost_ inclined to agree with a man who was in kimberley during the siege, who helped mr. cecil rhodes in his work there, and who afterwards, when asked if he was not glad that he had had the chance of assisting mr. rhodes in his great work, said, "yes, but when i think of all the suffering those unfortunate women and children had to endure, i think if i was ever again in a country where war was imminent, i should take a ship to the other side of the world, and stop there till it was over!" i fear that we are not likely all to be able to do that; but i trust this war will have had the effect of making people think, and that should there ever be another war in our time, we may be better prepared for it. war must always mean suffering, but the suffering might be enormously lessened if we were better organised in times of peace. printed by ballantyne, hanson & co. edinburgh and london _travel_ with pages of illustrations and two maps. small royal vo. s. d. net. nigeria: its peoples and its problems. by e. d. morel, author of 'great britain and the congo.' _times._--'the writing is clear and the opinions bold. mr. morel's personal impressions comprise many powerful thoughts and suggestions. his book altogether is one of distinctive value to the student and administrator.' large post vo. s. net. pastels under the southern cross. by mrs. margaret l. woods, author of 'the vagabonds,' 'the king's revoke,' &c. _scotsman._--'tell about the people and the south african life in chapters of never flagging interest, with every now and then a striking passage of description.' crown vo. s. d. net. a homeward mail: being the letters of colonel johnstone from india. edited by powell millington, author of 'to lhassa at last.' _morning post._--'there is much concentrated wisdom in his small book.' _scotsman._--'the colonel is never wearisome. his letters are full of pithy remarks and lively anecdotes.' large post vo. s. net. children at play, and other sketches. by miss bradley. _daily mirror._--'the author is most at home among the little ones of italy. she has made her subjects very attractive and human.' with pages of illustrations. small demy vo. s. d. net. an outpost in papua. by the rev. arthur kent chignell, priest of the new guinea mission. _church times._--'mr. chignell's book on papua is missionary literature of a refreshing kind. it is brimful of humour and humanity.' large post vo. s. d. net. two visits to denmark. by edmund gosse, ll.d., author of 'history of modern literature,' 'henrik ibsen,' 'father & son,' &c. _morning post._--'a book which in the guise of a quiet and delightful narrative gives you an insight into one of the most delightful countries of europe.' _daily mirror._--'it is full of an exquisite sense of humour.' _biography_ in two volumes, with portraits and plans. crown vo. s. the great duke. by w. h. fitchett, b.a., ll.d., author of 'deeds that won the empire,' 'fights for the flag,' &c. _liverpool post._--'written ... by a master of narrative. the history of the exhaustive peninsular campaign has never been written more picturesquely, yet with such regard to truth.' with a portrait in photogravure, and pages of illustrations. nd edition. demy vo. s. d. net. my naval career and travels. by admiral of the fleet the right honble. sir edward h. seymour, g.c.b., o.m., etc. _daily telegraph._--'simple, straightforward, manly, and unadorned, this literary record is a worthy tribute to the career which it describes. admiral seymour has to his credit as distinguished a career as any officer in the british navy.' with photogravures and pages of illustrations. in vols. large medium vo. s. d. net. the family and heirs of sir francis drake. by lady eliott-drake. _observer._--'the drake records are rich and so excellently managed and arranged by lady eliott-drake that we get a very close and vivid picture of life in devon and in london for nearly two hundred years.' with portraits in photogravure and illustrations. large post vo. s. d. net. 'sylhet' thackeray. by f. b. bradley birt, i.c.s., author of 'chota nagpore,' &c. *** a biography of william makepeace thackeray, the grandfather of the novelist. _standard._--'mr. bradley birt's knowledge of india, not only as it is now, but also as it was in the latter part of the eighteenth century, has enabled him to give the story a vividness which is not always found in anglo-indian biography.' with portraits ( in photogravure). small demy, vo. vols. s. net. the life of edward, earl of clarendon. by sir henry craik, k.c.b., m.p., author of 'a century of scottish history,' &c. _times._--'a life which in its greatness and variety of relief, no less than in the picturesque abundance of detail available, yields to five or six alone in the whole splendid gallery of seventeenth century biography.' large post vo. s. d. net. leaves of the tree: studies in biography. by arthur c. benson, author of 'the upton letters,' 'from a college window,' &c. contents:--introductory.--bishop westcott.--henry sidgwick.--j. k. stephen.--bishop wilkinson.--professor newton.--frederic myers.--bishop lightfoot.--henry bradshaw.--matthew arnold.--charles kingsley.--bishop wordsworth of lincoln.--epilogue. _daily telegraph._--'this may be accounted among the most valuable of all mr. benson's books.' with portraits ( in photogravure). demy vo. s. net. hannah more: a biographical study. by annette m. b. meakin, author of 'a ribbon of iron,' 'what america is doing,' &c. _aberdeen journal._--'miss meakin writes with profound knowledge of her subject. we have read the volume with deep interest and appreciation, and cordially recommend it to our readers as a treasure of good things, as well as an admirable account of hannah more.' with portraits. small demy vo. s. d. net. the annals of the irish harpers. by charlotte milligan fox. _standard._--'this fascinating volume, mrs. milligan fox writes excellently well concerning the traditions of the harp in ireland, and incidentally throws a flood of light not merely on the bards of ancient ireland but on historic harps which have been preserved until the present time.' with photogravure portraits. large demy vo. s. d. net. memoirs and memories. nd impression. by mrs. c. w. earle, author of 'pot-pourri from a surrey garden,' &c. _daily news._--'there will always be a welcome among a multitude of readers for a new book from the author of "pot-pourri from a surrey garden" ... book lovers will find a good deal to their taste in her latest volume.' chawton manor and its owners: a family history. with portraits in photogravure and numerous illustrations. crown to. s. net. by william austen leigh, fellow of king's college, cambridge, and montagu george knight, of chawton. _times._--'mr. austen leigh gives to his researches of the old hampshire manor a literary touch which lightens his extracts from the original documents. the personal interest for the public centres mostly about jane austen, her home and her family.' _fiction_ _new s. fiction._ rd impression. with illustrations by charles e. brock. the case of richard meynell. by mrs. humphry ward. _daily mail._--'no book of this year or next year is likely to be so widely and warmly discussed.' _glasgow herald._--'a tale which undoubtedly shows mrs. ward at her very best ... there is hardly a page in which we do not exclaim over some truly human touch.' the courtier stoops. by sir james yoxall, m.p., author of 'the wander years,' 'chateau royal,' &c. _times._--'sir james yoxall tells in the form of a novel the love story of goethe and christiane vulpius. and he tells it very cleverly.' penny monypenny. nd impression by mary and jane findlater, authors of 'tales that are told,' 'crossriggs,' &c. *** another story of scottish life and character from the skilful hands of the authors of 'crossriggs.' master christopher. nd impression by mrs. henry de la pasture (lady clifford). _the world._--'a fresh, delicate, and charming romance.' _standard._--'christopher thorverton is the best figure that lady clifford has given to us. from first to last he is consistent, human and touching.... erica is one of the best pictures of a flirt that we can remember.' enter charmian: a comedy idyll of moorside. by harold vallings. _athenæum._--'the reader who goes to this account of a golfing and shooting holiday, redolent of devon moor and folk, for genial amusement, will have his wish gratified.' the lost iphigenia. by agnes and egerton castle. _scotsman._--'a powerful story, strong alike in plot and characterisation, the study of dr. lothnar being perhaps the best thing these very able writers have given to the public.' _recent publications_ large post vo. s. d. net. the old order changeth. the passing of power from the house of lords. by frank dilnot. _standard._--'mr. dilnot is a parliamentary journalist with a seeing eye, a vivid descriptive power ... the student of our constitution will find the book invaluable because it supplies in interesting narrative the tale of the great dispute between the two chambers.' large post vo. s. d. net. judgments in vacation. by his honour judge edward abbott parry, author of 'the scarlet herring and other stories,' &c. _evening standard._--'this collection of essays is witty, full of amusing anecdotes, and besides that, is written with the literary sense which always dignifies the work of his honour.' _yorkshire post._--'humour is by no means the only rare quality in these judgments. in the pure lamb and stevenson sense they are literature.' large crown vo. s. d. net. the creed of half japan: historical sketches of japanese buddhism. by arthur lloyd, m.a., lecturer in the imperial university, tokyo, formerly fellow of peterhouse. _glasgow herald._--'this book is one that no serious student of japanese life can afford to overlook.' large post vo. s. d. net. the religious aspects of disestablishment and disendowment. by the right rev. bishop welldon, dean of manchester, author of 'sermons preached to harrow boys,' &c. _aberdeen journal._--'dr. welldon proves himself not only an extremely able, but a most fair-minded controversialist. to all that can be said in favour of disestablishment he gives full value.' large crown vo. s. d. net. copts and moslems under british control. edited by kyriakos mikhail. _scotsman._--'kyriakos mikhail has brought together a body of opinion and evidence in favour of greater liberty and increased privileges for the copts in egypt.' demy to. gilt top. £ s. net. a concordance to the poems of william wordsworth. edited for the concordance society by professor lane cooper, assistant professor of the english language and literature in cornell university. _liverpool daily post._--'this most admirable piece of work ... a concordance which is certainly excellent in design and which we have found most complete and accurate.' the centenary biographical edition of the works of william makepeace thackeray. for the purpose of this, the definitive edition, lady ritchie has re-arranged her biographical prefaces to the works, adding many new letters and illustrations, together with some writings of the great novelist hitherto unpublished. in vols. demy vo. gilt top. s. net each. the edition is printed in large type on fine paper. in addition to the very numerous illustrations in the text, there are about separate plates (many of them drawn by the author), and others by f. barnard. the hon. john collier. george cruikshank. frank dicksee, r.a. richard doyle. george du maurier. sir luke fildes, r.a. harry furniss. charles keene. john leech. sir j. e. millais, bart., p.r.a. g. a. sala. linley sambourne. frederick walker, a.r.a. the portraits of thackeray given as frontispieces, some of them appearing for the first time, are by the following artists among others: george chinnery. count d'orsay. charles keene. samuel laurence. daniel maclise, r.a. sir j. e. millais, bart., p.r.a. frank stone, a.r.a. frederick walker, a.r.a. samuel lover. the last volume includes a coloured portrait of lady ritchie, from a water-colour drawing by her father, and a sketch of w. m. thackeray, from a drawing by lady ritchie, both hitherto unpublished. _sir henry lucy._--'if you seek thackeray's best monument you will find it in this splendid edition of his works.' _sphere._--'now at last we have an ideal edition of thackeray ... beautiful books, well printed on good paper with adequate margins.' prospectuses post free on application. _finance_ crown vo. s. d. lombard street: a description of the money market. by the late walter bagehot. th thousand. with a new preface by hartley withers. _financial times._--'this well-known work represents a standard manual of the money market, and the new edition, brought up to date, will be appreciated by those who have derived help from the earlier editions.' _financial news._--'there is no city man, however ripe his experience, who could not add to his knowledge from its pages.' _works by hartley withers_ _large post vo. s. d. net each._ the meaning of money. th thousand. rd edition. _financial news._--'there can be no doubt that mr. withers' book will supersede all other introductions to monetary science ... readers will find it a safe and indispensable guide through the mazes of the money market.' _daily mail._--'a book for the average man. volumes upon volumes have been written to explain and discuss our monetary system. now we have a work worth all the rest put together in clearness of exposition and elegance of diction.' _manchester guardian_ (leading article).--'no common measure of literary accomplishment, a lucid, forceful, and pointed style, and a great store of material for apt and often amusing illustration have lent both grace and charm to a work of quite exceptional utility.' stocks and shares. _world._--'"stocks and shares" is attracting a lot of notice in the city. it is full of information for both speculator and investor, and is written with a brightness and humour that prove the possibility of dealing with the driest of subjects in an attractive manner.' _morning post._--'it is a good book, it is sure of its public, and if the laymen who read it will only follow mr. withers' advice more than one "bucket-shop" will be closed till further notice.' _daily news._--'should be of the greatest value to investors and all who take an interest in city matters.... it is eminently readable, and the description of a typical flotation, "hygienic toothpowder, ltd.," is a literary gem.' london: smith, elder & co., waterloo place, s.w. _at all booksellers and bookstalls._ smith, elder & co.'s new s. net series. . deeds that won the empire. dr. w. h. fitchett. . the cruise of the "cachalot" round the world after sperm whales. frank t. bullen. . fights for the flag. dr. w. h. fitchett. . the log of a sea waif. frank t. bullen. . the gamekeeper at home. richard jefferies. . a londoner's log book. rt. hon. g. w. e. russell. . the sowers. h. s. merriman. . jess. h. rider haggard. . vice versâ. f. anstey. . woodland, moor, and stream. j. a. owen. . the tale of the great mutiny. dr. w. h. fitchett. . sixty years in the wilderness. sir henry w. lucy. . a vision of india. sidney low. . the defence of plevna. capt. f. w. von herbert. with an introduction by general sir john french, k.c.m.g., k.c.b., etc. . the memoirs of sherlock holmes. a. conan doyle. . nelson and his captains. dr. w. h. fitchett. . with edged tools. henry seton merriman. london: smith, elder & co., waterloo place, s.w.