A Nurse at the Front, The First World War Diaries of Sister Edith Appleton

August 13 [1915]

Last night was remarkable for two terrific explosions which woke us at 2 a.m. and frightened us out of our wits. People have various theories of what they were - Zep[pelin] bombs, mines being exploded or our own guns a field or two away. The whole building trembled and rattled with the vibration. Have been feeling thoroughly nervy all day, silly fool that I am.

August 14

Evacuated nearly all patients, so had half day off duty and spent it at Mont des Cats with Miss Congleton. Delightful sunny day with splendid views all over Pop[eringhe], Ypres, Vlamertinghe. A Roman Catholic padre left his binoculars us, so we had a wonderful clear view beyond La Bassée, and the colours of the sky at sunset were glorious. As it got dark we saw them sending up coloured rockets from the aerodrome. . . Shells were bursting over our trenches south of Ypres. The picture was vivid, and the huge volume of smoke and muck shot up into the air gave a suggestion of what was happening to our Tommies. All the time the khaki-coloured ambulances were creeping to and fro, bringing the wounded in. 

This was one of the books that Mary Robinette Kowal cited as background reading for Ghost Talkers, and I put it straight on to my reading list. I've read only one other diary from World War I (as opposed to memoirs), and it was also from a nurse, the American Helen Dore Boylston's "Sister." Like Boylston, Edith Appleton was a trained nurse, though she had years more experience before she joined Queen Alexandra's Imperial Nursing Service Reserve. A month later, she was at her first posting in France, and by February she had moved to the front. She served in hospitals and casualty stations across France and Belgium. After the Armistice, she remained to help with the transport of convalescent soldiers. The diary she kept was apparently sent home on a regular basis to her mother. In 2008, her family built a website to honor her memory, and the publication of her diaries followed.

It is clear from the entries just how hard Appleton and the other nurses worked, and how exhausted she often was. The exhaustion wasn't just physical either. Appleton took every chance she could to get away from the work, noting long walks and picnics, and writing about the "splendid views" and the scenery around her - as well as the contrast with the columns of "smoke and muck" and the long lines of wounded and dead. She appreciated simple comforts where she found them, sharing biscuits and chocolate with a friend on a walk, relaxing with a book for a few minutes. When she was assigned to a unit temporarily housed in a wing of a "lunatic asylum," the director offered the nurses the use of the patients' bathroom.

I don't fancy bathing in company, but since I have not sat in water deeper than an inch since last year, the temptation is great. . .Three of us went up to another part of the asylum at 7 a.m, and had a deep BATH! Up to our necks in water - glorious! A dear old nun came trotting in when I was in my bath and felt to see if the water was the right heat. She thought the bath was too full and pulled the plug by a patent in the floor. I was sitting on the hole where the water runs away and was sucked hard into it!

Even more than a century later, it is difficult to read about the suffering of Appleton's patients. She didn't go into gruesome detail, perhaps because she was writing for her mother, but she didn't gloss over things either. She recorded the first use of gas in the trenches, and its effects on the men coming in to her ward. She noteed the deaths of individual patients who somehow stood out amidst all the carnage. She tried to give them all a clean handkerchief, because that small thing brought them great comfort. This is not a comfortable book to read - and it shouldn't be - but it is a wonderful record of one part of the Great War by a brave, observant and compassionate woman.

Rushed off her feet

One Pair of Feet, Monica Dickens

My introduction to Monica Dickens came from Barb's review of this over on Leaves & Pages earlier this year, which really piqued my interest.  As I know I've mentioned before, I've loved stories about nursing schools for as long as I can remember.  With my mother, two of my aunts, and several glamorous older cousins who were all nurses, I read every book I could find about student nurses while I waited my turn.  I thought I knew all about the hard work on the wards and the even harder classroom studies, the dorm and ward pranks, the handsome doctors, the variety of patients and fellow students (always one know-it-all, one loner, one madcap life of the dorm).  An account of nurse's training would have been enough for me, but add in the excitement of training near London in the early days of World War II, and I had found a copy on-line before I even finished Barb's post.

Because I have this need to read stories in order, though, I started with Dickens' first volume of memoirs, One Pair of Hands, and then went on to read her marvelous autobiography, An Open Book.  So when I sat down with this one, finally, I already knew quite a bit about her nursing career, both before and after the book was published (she was blackballed from nursing for a year or so after it came out; when she finally found another hospital to accept her, she had to begin again as a probationer).  Maybe that's why I liked it, rather than loved it - because it felt almost like re-reading?  Perhaps it was also because it wasn't quite what I expected.  Though the book opens with Dickens trying to decide among the many options that war work suddenly offered to women, once she settles into the Queen Adelaide Hospital [standing in for the King Edward VII], the war doesn't play much of a part in Dickens' story.  It seems very much the background, with the soldiers at dances, the passing references to air raids in London and to rationing.  But maybe that was deliberate on Dickens' part, to provide some distraction and a bit of comic relief.

In her autobiography, Dickens quotes a nurse who wrote that "either the book was fiction, and therefore lies, or the hospital should immediately be 'struck off the lists of approved hospital training centres.'"  I don't know if it was the war conditions, or differences in training, or just the way that Dickens told her story, but I didn't see much actual training going on.  She and her fellow probationers were sent on the wards their very first day, and they were put immediately to work doing the most menial tasks.  None of the senior nurses seemed to have any time for them, and it's a wonder to me that the probationers, run off their feet, learned anything of nursing.  Eventually they began taking classes, with an eye toward the exams they would have to pass, but these get barely a mention.  Most of her story focuses on the wards, as the students are transferred around the hospital in rotation, in and out of night duty.  Dickens turns those oh-so-observant eyes on her fellow students, the senior nurses and the Sisters who rule the wards, and the patients who occupy them.  That's where her interests lie, those are the stories she tells, with wit and irony - and often with empathy.  I didn't learn much about her training as a nurse, but I did come to know the people who made up the world of the hospital, down to the maids on the wards and the porters in the halls.  And as with her account of life as a cook-general, Dickens doesn't hesitate to share her own screw-ups and failings.  My favorite came from her very stressful turns in the operating room:

I personally was terrified of all surgeons and hated having to go near enough to do up their sterile gowns or to wipe sweat from their brows.  Once or twice I had touched them and made them unsterile and I wished myself dead as I received their reaction at having to go through the whole scrubbing-up business again.  My greatest shame, however, was when one of them suddenly shot at me through his mask: 'Fetch me the proctoscope!' and never having heard of the instrument before, I heard it as something else and came trotting faithfully back with the white coat of the night porter which I had dragged off his indignant back.

Dickens writes in her autobiography that, when she began her training, she thought that perhaps she was done with writing, that nursing would be her new profession - one she experienced almost as a vocation.  In the end, it would of course be writing that she chose.  I'm glad that I still have her third volume of work memoirs, My Turn to Make the Tea, as well as so many of her novels to look forward to.

Henry Street nurses

Sue Barton, Visiting Nurse, Helen Dore Boylston

I've posted before about my attachment to the Sue Barton books.  As an adult, I was able to find my own copies of the books through the internet, except for one.  There were very few copies of Visiting Nurse listed and they were far out of my price range.  Last month I discovered that a company called Image Cascade is publishing new paperback editions, with vintage covers, and I ordered Visiting Nurse.  I've found the other books to be a bit dated but still enjoyable reading, reminding me of why I loved them so much as a kid, and I was curious to see if this one held up as well.

Visiting Nurse is a fictional account of six months spent working with the Henry Street Nursing Service, part of the Henry Street Settlement work in New York City.  I don't remember ever thinking that much about the setting, but now that I've read about Jacob Riis and visited Hull House in Chicago, I realized that nurses in this book were either a real group or based on one.  With a quick google search, I learned the reality behind the book, which even includes a cameo by the founder, Lillian Wald.  I don't think Boylston ever worked with the program, from what I can find, but she clearly admired their work, which she showcased.

In the book, Sue's work takes her through the crowded slums, in and out of tenements, meeting the diversity of peoples that make up the neighborhoods.  Many are recent immigrants or migrants, and Boylston skirts the edges of caricature with her Irish and Italian patients.  Sue is later transferred to a district in Harlem, where many of the African American characters sound like Prissy in Gone With the Wind, yet Boylston clearly wants to portray them in positive ways and condemn racist attitudes.

A major plot element revolves around women's careers and marriage.  Connie, a close friend from training, is engaged and will marry soon, abandoning her career, which Sue privately considers a waste.  Another friend from training, Kit, who joins Sue at Henry Street, seems to be focused on a career, with no thought of marriage (like Boylston herself, perhaps).  Sue is engaged to Bill, a young doctor she met during her training, and she wants to be married but isn't yet ready to give up her own work.  Henry Street nurses can be married, though in 1939, when the book was published, nurses and teachers often had to give up their work at marriage.  By the end of the book, Sue seems poised to have both marriage and a career, working with Bill in his country practice as a rural district nurse.  Since my mother worked as a nurse for most of my childhood, I took it for granted that women could do both (though without realizing how difficult and draining it could be).  I apparently also took for granted that all the doctors are men and the nurses women; I don't think there is a single female doctor in the entire series.

Now, though, I want to read more about Lillian Wald and the real world of the Henry Street Settlement.

An American nurse in the Great War

"Sister,"  Helen Dore Boylston

I have loved the Sue Barton books, by Helen Dore Boylston, since I was a kid, and I have five on my shelves today.  My mother was a nurse, and I was in love with the idea of going to nursing school.  Other girls might have been reading about boarding schools and wishing their parents would send them to the Chalet School.  I wanted to follow Sue Barton and Cherry Ames to nursing school.  I've forgotten most of the other series, but I still re-read Sue Barton (and I much prefer her to the less realistic Cherry Ames).

I never gave much thought to the author, though.  I don't know if the library copies I read even had an author note; if they did, it didn't make any impression.  In just the past few weeks, thanks to the internet, I've learned that Boylston served as a nurse in France during World War I; that she kept a diary of her experiences, which she later published; and (most surprisingly to me) that she became close friends with Rose Wilder Lane, with whom she took a driving tour from Paris to Albania in 1926.

I still feel, after reading Testament of Youth, that I know far too little about the First World War.  So I got Boylston's nursing diary, "Sister," from interlibrary loan.  I thought it would be an interesting companion to Testament of Youth.  Boylston, a trained nurse and an American, kept a diary that she published in 1925. Vera Brittain had no experience when she left Oxford to volunteer as a V.A.D. nurse.  Her Testament is a memoir, published in 1933.

Boylston's diary opens in February, 1918, at a convalescent hospital in Paris Plage, where she is recovering from flu and trench fever.  There is no introduction, no background, nothing to tell us how she came to be in France. A later entry mentions her third anniversary in France, but it's not clear if she only kept a diary in 1918 or only chose to publish the last year's entries.  From other sources I learned that, soon after her graduation from nursing school, she volunteered for service with a medical unit from Harvard.

Boylston details the day to day life of the medical station, which from what I can tell was located on the western coast of France, near Le Touquet.  She records her fellow nurses, the patients she cares for, the different wounds they suffer, the arrivals of yet more wounded, and the terrifying air raids that go on for weeks.  But the diary is just as much about her time off-duty, getting all the fun she could out of life to balance the mud, the fear and the death.  There is very much a "seize the day" flavor to her entries, especially with regard to the men she dates.  Normal rules and moralities don't apply; married men are considered "war rations," available for the moments of fun snatched between bombs and 48-hour shifts in the operating theatre.  Brittain's Testament is much more sombre in tone, reflecting of course the loss of her fiancé Roland Leighton in 1915, perhaps Brittain's different temperament, and also their different circumstances.  Boylston doesn't mention any relatives or friends in the armies. In addition to her fiancé, Brittain lost her only sibling Edward and two of their best friends in the war.

When Boylston returns to the United States in January 1919, like many veterans she finds the adjustment difficult:

"How we worked! We gave all we had to give, and life was glorious. Even numbed with fatigue as we were, we knew it was glorious. . . I can't stand it here much longer, in this place where nothing ever happens and every day is like every other day."

On the last page of the book, we learn that she has volunteered again, for the Red Cross, and is sailing to Paris.  As far as I can discover, she never wrote of those adventures.

I can't say I learned much about the Great War itself, but I caught at least a glimpse of what it was like to be part of that war, caring for those who fought it.