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8 The American Journal of Nursing 

2. The advantages of an International Council of Nurses for the 
furtherance of the social and professional progress of nurses, and for 
the maintenance of a high standard of nursing ethics and esprit de 
corps. 

3. The advantages of the affiliation of international societies of 
experts with the International Council of Women for mutual intellec- 
tual expansion and organization. 



IN HOSPITAL 

By M. E. R. 
I. LOW FEVER. 

There was a " service of song" at the Methodist chapel across the 
way. As the noise came through my open window I could imagine the 
chapel interior — the air palpitating around the gas-burners, the unvary- 
ing type of face in the perspiring congregation, the cheap attempts at 
decoration, and the stifling smell of the place. On the hottest night of 
midsummer they were singing the delights of the Heavenly Jerusalem, — 

" To be there, to be there, 
Oh, what must it be to be there!" 

So the words ran, as the stiff, untrained throats of the singers, failing at 
the higher notes of the refrain, flattened in horrible discord. 

Sickness destroys one's power of resistance to external impressions, 
I suppose, for as I lay there, helpless to get away, the Heaven they sang 
of seemed insistently near. 

Pain was not so bad, after all, though my head and side throbbed 
furiously; and there might be worse than to lie in the dark in a strange 
room, consumed with thirst. Who was that invalid, I wondered, who 
made a practice of cataloguing all the small pleasantnesses of her daily 
life, recalling them in the night watches ? The way a bird cocks his head 
on one side when he looks at you, the shock of cool, fresh water in the 
morning, the first dip into a new magazine as you cut the leaves, — these, 
as I recalled them, were some of the things she cared to record. But I 
recalled them with difficulty, could not realize them at all, for that 
intruding conception of a Heaven all tinsel and noise. 

It had been a fatal year for typhoids. Perhaps a lurking fear of 
being ridiculous had saved me, so far, from taking my condition too 
seriously ; but fever plays queer pranks with one's brain, and, for a bad 
minute, the fear, not of death itself, but of going to an orthodox Heaven, 
held me as in a vise. 



2 

m 
o 




In Hospital— M. E. R. 9 

I struggled, to get free. Why not make my own catalogue of pleas- 
antnesses? That very afternoon, as the stretcher was lifted from the 
ambulance, had it not been a pleasant thing to look up and recognize 
the particular beauty of the sky which follows a cloudless summer day ? 
The high-hanging clouds were becoming visible, but delicately so ; they 
were just beginning to make ready for the splendors of a late sunset. 
It was only a brief glimpse — in a moment the bearers were carrying me 
along the hospital corridors ; but really to see the sky one must look it 
squarely in the face, and the best way to do that is to lie flat upon one's 
back. Then, by contrast with the throaty noises of that congregation 
across the way, what a pleasant thing had always been the moment of 
suspense when Arthur Mkisch stood above his men with baton raised, 
and every trained muscle, every disciplined will, was alert to give with 
purity the first full, satisfying tone in the strings. A moment later> 
when the first beat had been given, the first stroke made, how the nerves 
vibrated in sympathy along one's spine and to one's finger-tips ! There 
was another pleasure, and a still better one, — to sit in a corner in the 
dusk and hear A touch the piano ; to know just what she was think- 
ing, — but that thought had too many associations, and sent me drifting 
helplessly. 

The woman next door could not sleep. She kept up a moaning, 
broken by whispered complaints to her attendant. The ward was wakeful, 
apparently ; for, though the chapel people had turned out the lights and 
gone home long ago, and the clock had struck ten and then half -past 
with what seemed a long night between, every few minutes a bell would 
ring, summoning the nurse, and far off a man howled continually in 
uncontrollable agony. Somehow I did not mind his noise as much as I 
did my neighbor's — he could not help it, poor fellow. 

Moonlight streamed into the corridor and slanted through my open 
door across a section of the floor. The outside world was breathlessly 
still, but a contagious unrest seemed to pervade the hospital. I listened 
intently for each sound, waited to be shaken by it, then turned and tossed 
and listened again. 

It seemed so long since the nurse had been near me to arrange my 
pillow or bring me a drink, and the unspent hours of the night stretched 
endlessly far before. Even those church people might have made an 
agreeable diversion now. But that was the nurse's light tread along 
the hall, and I heard the cool tinkle of ice in a glass. Had she passed 
my door, I should have weakly cried, I think; but no, she came in, 
the tinkling growing clearer and clearer. Talk of symphony orches- 
tras ! The pleasantest music in the world is made by a lump of ice in 
a glass. 



10 The American Journal of Nursing 



II. DOCTORS ROUNDS. 

When one is lying in such unaccustomed helplessness, a hint of 
helplessness outside means panic. The almost military discipline of the 
hospital is, therefore, the patient's best prop. In so far as the extreme 
heat relaxes this discipline, — some of the force usually being away, 
house-cleaning in progress, and quiet more difficult to maintain, — just 
so far is the patient's recovery retarded. My room was at the end of the 
downstairs or women's ward, and convalescents and their friends gathered 
on the veranda outside to compare notes about all the diseases they had 
ever known. Under this strain my temperature was mounting steadily, 
when the doctor had me moved upstairs to a quieter room in the men's 
wing. When their pain was unbearable the men howled, but they talked 
very little. My satisfaction in the change seemed to afford the doctor 
some amusement, but then, though I hardly was conscious of it at the 
time, he afforded me amusement too. 

The doctor, his assistant, and the head nurse go the rounds together 
just after breakfast. There is a certain order of procedure which is, I 
believe, invariable. The doctor raps, enters, shakes hands with the 
patient, sits down ; the nurse stands at the foot of the bed, instruction- 
book and pencil in hand; and the assistant, carrying an ink-bottle and 
the record of your case, stands by the mantel, ready to write down new 
symptoms. 

On the first morning the doctor entered as if he were coming into 
a drawing-room, and paused with an alert air, ready to take the smallest 
hint. I got the impression of an athletic figure and capable head — still 
young and smooth-faced, but with a not very satisfactory mouth. Capa- 
ble of subtlety, he yet was about to make the initial mistake of an indul- 
gent manner. Was I thirsty? Well, I might have all the water I 
wanted; the nurse would please put that down. And did I care for 
aerated waters? Well (with an air of conceding much), there was no 
objection to the indulgence; the nurse might put that down also. At 
which I did not laugh in his face, because laughing was too great an 
exertion. 

I was in a half-stupor during the week that followed. A direct 
question seemed worse than a blow, and the man who called " Huckle- 
bays!" a block away, and the other man who ground a piano-organ 
beyond the hospital enclosure, were no longer merely the sources of 
street noise. They marched across my line of life and back again, 
making queer, crooked turns in my dim consciousness; they advanced 
and retreated in waves of colored sound; between them it was to be 
settled whether I should live or die. 



In Hospital— M. RE. 11 

III. HIGH FEVER. 

Why did you say — that night so long ago? — 

We speed so fast, though, I could never hear; 

Our steeds drag headlong through the molten air ; 

The white track blinds me, and the whole world throbs 

With pain — a senseless, brute, ignoble pain. . . . 

Are you still there? Do not come near, nor look, 

But just in pity tell me why you ever said — 

Faster, faster, lash the horses on! 

The wind blows hotter and the throbbing grows, 

But Hell itself can no new horrors hold 

To match these surging, upturned heads. They sink, 

They rise, they crowd upon us here — a sea 

Of tragic faces, loathsome, terrible, 

And your face too ! Time was when just your look 

Made heaven. Ah, when was that? Ages ago, 

I think. You died since then and never said — 

Why did you ever say — in pity tell — 

Nay, but I will know, grappling you and Death. 

I would not break your arm, dear nurse. Yes, 
Your hand is cooling; hold it there awhile. 

IV. DETACHMENT. 

When a fever at last burns low, and the patient has had no solid 
food for weeks, there comes a period of clear-headedness, of keen sensa- 
tion, during which, if one were only stronger, — tantalizing thought, — 
one certainly must be far cleverer than common. When this period 
came for me, I lay long hours of the summer days quietly thinking. 
The mood was one of detachment. I had no desire to establish relations 
with the people who moved in and out my sick-room, for old memories 
were my company — old memories of books, places, and people. These 
I read anew with quickened insight, new standards of measure. Some 
such experience everyone has had, I suppose, in the moment between 
sleeping and waking, when a vexing question will seem luminously clear, 
only to be obscured again by the shock of contact with reality. Happily, 
no such disillusioning test was to be applied to my invalid thoughts. I 
believed in them then and I believe in them now, though of what they 
were about I have no very clear recollection. 

A period of such beatific self -content could not last long. It was 
succeeded by a craving for books, or not so much for books as for one 
particular form of literary thought and expression. All reading was still 
denied me, so there was ample time to think out the details of this form. 
It must be prose, but imaginative and finely done ; not fiction either, for 
fiction would be too much like fact. Some prose study was what I wanted, 



12 The American Journal of Nursing 

and I tried to think of all the essayists in turn. The eighteenth-century 
men were too artificial. Macaulay*s sledge-hammer periods were out of 
the question, Lamb's whimsicalness spoilt him for the time, Arnold was 
too controversial, Emerson too thin-blooded, and De Quincey, who might 
have done very well, escaped my mind. 

When it was grudgingly conceded that A might read to me an 

hour a day, she came with a bundle of new magazines. They seemed so 
inadequate to the occasion that my face betrayed me. I tried to explain 
what I had in my mind, and, though I was incoherent enough to have 
puzzled anyone else, the right book was promptly at hand the next day. 
With the first sentences I knew that here was what I wanted. A high, 
weather-stained wall in a sculptor's yard, the cool close of summer at 
Valenciennes as the eighteenth century begins, and then the growth of 
Watteau's art traced step by step in the journal of a girl of the Prov- 
inces, his cousin. He had, she says, in her effort to catch the distin- 
guishing characteristic of his style, his "cleanly preferences." What 
an admirable trait ! so far removed from the brutality of false emphasis, 
of high fever. It seemed the secret — through all that delightful book, 

as A read it to me on three successive afternoons — of Pater's own 

style. But one progresses rapidly from this stage. Before " Imaginary 
Portraits" was finished I had begun to watch the people about me, and 
my first step back into the world of men and women had been taken. 

V. CONVALESCENCE. 

One of the nurses was a rich Philadelphia widow in her Second 
year of training. The world and its allurements had palled upon her, 
and she proposed to dedicate herself to the slums. She could not have 
been more than thirty-r-one of your warm-cheeked brunettes and good to 
look upon, — or she would have been good-looking had she never moved 
or spoken; her Delsartian gestures and the self-conscious modulations 
of her voice filled one with distrust of the bloom. 

Sentimentality had marked her for its own. I knew it by the lifted 
eyebrows and the frown of pain between them as she counted my pulse 
and adjusted my pillow. I knew it by the guarded yet confidential tone 
in which she referred to " Mareella." Five of her friends had sent her 
copies of the book, and were foolish enough to think her like the heroine. 

No wonder the world failed to satisfy her! But the slums must 
fail too. I pictured the cowed awe with which so much manner must 
at first oppress them, and, later on, the savage force of their revolt. 

Passively to have received the ministrations of such a nurse for long, 
the humor of the situation must have worn off — it must have become 
intolerable ; but, happily, I escaped this. My own nurse was somewhat 



In Hospital— M. E. R. 13 

angular, — she stooped, in fact, — but there was a merry twinkle in her 
eyes, especially when they lighted on the widow, which gave assurance 
that one might trust her to take hold of life by the right handle. She 
laughed at me and my returning appetite, and fostered my interest in 
the hospital life by graphic little sketches of her associates and of the 
other patients. By the time I was promoted to a wheel-chair I knew 
something about each one of these. 

There was the poor fellow from Canada to whom she had carried a 
cluster of my bunch-berries as a reminder of home. He had been very 
ill with the fever and a sister had come to nurse him. When he was 
well enough to be read to, the sister went into town to get some attractive 
literature, and brought back Stead's " If Christ Should Come to Chi- 
cago." Then there was the old German organist who had never missed 
a service for fifty years, and, waking one morning to find one side 
paralyzed, had received this stroke of fortune with the petulant surprise 
of a small child. I had known his playing — a dry, scholastic style, and 
had seen a text-book of his on counterpoint and thorough-bass. It ap- 
peared that the old gentleman was also a student of the Swedenborgian 
metaphysics, but these studies had failed to prepare him for the turn of 
events which suddenly had flung him on his back — it seemed to him 
altogether unreasonable, unprecedented. He was a troublesome patient, 
always ringing his bell and demanding the impossible, but I noticed that 
the nurses liked him. They seemed to feel that his unworldliness had 
received a shock, that one who had spent his life with the abstractions 
of musical mathematics and of the seven spheres needed time to readjust 
himself to the hard facts of life. I also noticed that not one of them 
had any patience with a little Hebrew at the end of the ward, who had 
been a mere bunch of acquisitiveness, probably, until rheumatism gripped 
him. ]STo doubt he had suffered, but his inordinate demands were in no 
sense an effort to adjust his sufferings to a philosophy of things; they 
seemed just the old, life-long habit of asking for all he could get. 

My nurse said that there were not so many " characters" in a pay 
ward, and that nursing in a free ward was for that reason more interest- 
ing work. There was an Irishman in the free surgical ward, she told me, 
for whom was prescribed two ounces of sherry daily after dinner. There 
was little hope that he could get well, but the sherry was always occasion 
for a toast, and he would propose his nurse's health in such a speech as 
only an Irishman can make. 

I never saw him, but the patient for whom I had the friendliest 
feeling was a German in the free surgical. Death for him was only a 
question of a few weeks. He had no relatives or friends, but a fellow- 
countryman had agreed to pay his funeral expenses. This was not only 



14 The American Journal of Nursing 

a satisfaction to him — it was a source of the greatest pride. Whenever 
he had a bad turn he would always see to it that a letter was dispatched 
to prepare his benefactor for the worst. In the year and more of his 
sickness he had become an excellent judge of nursing, and his rebuke to 
the nurse who omitted the smallest item of his toilet was dignified but 
scathing. 

Whatever had brought him to this pass (and he was silent on the 
subject), inefficiency certainly was not the cause. He selected the capa- 
ble people on the hospital staff with an unfailing instinct, and their 
sympathy went out to him in return. Hopeless as his state was, 
he wasted not one moment in vain regrets, but, gathering his remain- 
ing strength, faced death with no smallest decency of life neglected. 
Absolutely clean and well-brushed he must be to the end, and then — a 
respectable burial. 

I thought of him on my last night in the ward. Evidently my time 
to die had not come, as I was to be dismissed, cured, on the morrow ; but 
when it did I should be glad to bear myself as well, should envy him his 
quiet and unfailing courage. 



THE FEEDING OF INFANTS 

By JOHN LOVETT MORSE, A.M., M.D. 

Instructor in Diseases of Children, Harvard Medical School ; Assistant Visiting 

Physician at the City Hospital and at the Infants' Hospital, Boston. 

Everyone must admit that the natural food for a baby during the 
first year is human breast-milk, and that this should preferably be its 
own mother's milk. "Unfortunately, however, the modern woman, proba- 
bly as the result of civilization and unnatural surroundings, is often 
unable to nurse her offspring. In such cases, of course, some substi- 
tute must be provided. Every woman, however, who can, even if only 
partially, nurse her infant should do so, as there is no question that 
babies thrive better on breast-milk than on any substitute food. The 
mother who can but does not nurse her baby voluntarily handicaps it in 
its struggle for life. 

BREAST FEEDING. 

It is not enough, however, merely to nurse a baby; it must be 
nursed in the proper way. The baby must be trained to nurse at regular 
intervals, and only at those intervals. The proper training of a baby, 
and especially the regulation of its hours of feeding, almost makes the 
difference between its being a blessing or a curse to the family. The