Children's Hospital, London,
June 1891.

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 9 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 7 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 6 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 104 and 105.

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.

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