Book Review - The Girl in His Shadow by Audrey Blake

The cholera outbreak in London in 1827 was considered ended when, three months later, there was another outbreak. Dr. Croft, a noted physician, had made many calls to his patients. A last call to the Beady household found three people dead and one eight year old child still alive. The doctor picked her up, despite possible contamination, and took her home to his housekeeper, Mrs. Phipps. He was scolded roundly for bringing contamination to the house. They nursed little Eleanor Beady back to health.

Grisly, humorous, women’s issues and the state of health care in the late 1800s. Parented by Dr. Horace Croft, a brilliant and very distracted physician, and Mrs. Phipps, his stern housekeeper, Eleanor (Nora) grew up to assist Dr. Croft in his many experiments on cadavers. She learned surgical techniques, practicing on cadavers. She studied all the books and papers that she could lay her hands on. She learned to love the search for answers. Answers to the many questions about the workings human body. 

Dr. Croft had a professional enemy in one Dr. Vickery. They not only disagreed but they disliked each other intensely. Dr. Daniel Gibson, a young doctor, came to work and live with Dr. Croft taking very a cherished spot with the great man. Here the story also turns to the place of women in the 1840’s. Dr. Gibson disapproved of Nora and her work in the surgery and her lack of refinement. More than just socially unacceptable, some of the surgical work she did was illegal as she was not a licensed physician. London’s Royal College did not admit women. The nature of her work wth Dr. Croft had to be kept secret, especially from Dr. Vickery. Dr. Harry Trimble, a friend and colleague of Dr. Gibson’s became a wild card in this scenario of learning, medicine, deception and romance. 

Eleanor (Nora) had only one year of finishing school. Her socialization involved taking care of patients and keeping Dr. Croft’s surgery spotlessly clean. Rather than embroidery, her stitches were sutures. As the story progresses, Nora’s status as an illegal practitioner of medicine - and a woman at that! - is finally exposed. It was then that Nora actually stood up for herself. The results were….. to tell you more would not be fair. 

Well researched, the novel included the names of famous women of medicine and nursing. I loved this book, it’s a keeper! Good character development - I liked them all, except of course, Dr. Vickery who was just not likeable. The end left me wanting more. Gladly there is a sequel in the offing, but no publishing date as yet. 

“Ears ringing, Nora rose to her feet, her voice floundering 

under a wave of noise from the crowd.”

~ Nora, The Girl in His Shadow

Title: The Girl in His Shadow

Author: Audrey Blake (creative alter-ego of Jaima Fixen and Regina Sirois)

Copyright: 2021 by Jaima Fixen and Regina Sirois (co-authors)

Publisher: Sourcebooks Landmark. An imprint of Sourcebooks

Type: Novel

Format: Paperback

ISBN: 9781728228723

ISBN: 9781980091479 (audiobook)

Ebook: 9781728228730

Chapter One, Episode 144 - Another Step Forward - Situationally Theirs

Review, Revision, Edit and Update

This episode interested me. As I began my review, it almost felt like a repeat of yesterday's Review. As I continued reading it, this episode was the scene from the other side of the telephone call between Emelina and Jeremy from the yesterday's Review; rather like hearing two opinions about the same issue. 

Because I am so late today with this, I was pleased that there were only a few typographical errors to fix in this episode.

Another Step Forward

It is easy to deny and not see the effects of something tragic if we don’t see the tragedy in front of our eyes.We could stay closed up in our homes and not allow anything tragic to enter our lives. Jeremy could talk himself hoarse, and did many times, about the precautions against Covid19. He hoped desperately that it wasn't quite so easy to deny this global viral reality. However, even Jeremy had felt that denial when he was away from the hospital, when he was out at the beautiful green Beaufort Estate, when he and Emmie were walking on the wide open beach, wading barefoot in the lapping cool water. He just wanted to deny it all. Like he had when Elaine died. It hadn’t worked then and it wasn’t working now. As a physician, he could not, in good conscience, walk away from the hospital and his patients. He had closed his private practice so he could work shifts at the hospital. Before the pandemic, he was able to keep up with both. He limited his private practice to only those that had been with him from years He accepted no new patients and felt guilty about that. But Jeremy wasn’t getting any younger and had to take care of himself, so with sadness he let go of a practice of 25 years so he could give the hospital more of his time.

Starting his shift at 11pm, he was given hand-off report from the young physician that evening who was anxious to get off on his date. He tried to get him to work the earlier part of his shift as well, but Jeremy said a firm no. One extra single night shift was enough, not a double shift. On this Covid unit, it was a fairly standard group of patients. The nursing complement was barely adequate for the patient load. Fortunately, most of the patients were almost ready for discharge, two were still quite ill with Covid19, but were out of danger. One woman, just admitted from Emergency, should have been in ICU, but there were no beds available. She would be on a portable respirator until a bed came free. He spoke quietly to the nurse who was caring for her. She told him of the patients anxiety about an old photo she had with her. When he went in to see this woman, he saw the picture pinned to her pillow. The girl in the picture looked very familiar. But it couldn’t be. The woman’s eyes fluttered open, she reached up and touched the picture, making certain it was still there. “Hello, Mrs. Tyler.” He glanced quickly at her hospital ID band. “My name is Dr. Crawford. I’m the doctor on call tonight for this unit. The nurses and I will be taking care of you. The nurse told me you want that photo to stay close.” Mrs. Tyler nodded weakly, a tear drained onto the pillow. “We’ll make sure it stays pinned and close. I’ll let you get some rest but will be back to check on you shortly.”

Mrs. Tyler’s nurse was finished preparing the patient’s medications and was just leaving the nurses’ station. “Before you go to Mrs.Tyler, did you get a name for the girl in the picture? Was she able to tell you who it was or if the girl was family?” Monica Green, the RN in charge of the unit and of Mrs. Tyler, set the medication tray down and picked up her chart. “I wrote the name on a card and put it in the front of the chart. Her name is……let me see….oh, yes, here is it. An Emelina Eliot.” Jeremy paled. “Are you all right, Dr. Crawford? It’s just an old photo, quite worn. There was no other information on it and we had to intubate her right away. It’s probably just a picture she picked up somewhere.” Monica picked up her tray and excused herself, getting on with her shift. 

Dr. Jeremy Crawford looked up at the clock. It was well past midnight so, gowned, gloved and masked, he set about on his rounds. Most patients were sleeping soundly, some a bit restless but in general the unit was quiet. Miss Green was still in with Mrs. Tyler so he just passed by the room. Returning to the nurses’ station, Jeremy sat down and, for the next hour, went through all the patient’s charts, reading medical histories, most recent nursing notes, and skimming the vital signs flow charts as well as previous physician’s orders. There was little on Mrs. Tyler’s chart except since her admission to Emergency. She had not been in Hartley long and this was her first admission to Hartley General. He put all the charts away, then stood in the centre of the nurses’ station, hands at his side, wondering how he could learn more about this Mrs.Tyler and the mysterious photo of a young girl that looked so familiar. Her belongings. I need to check her belongings.The phone rang. Jeremy looked around for a nurse or other staff member. When no one was in sight, he picked it up. “Dr. Crawford - Covid unit. Can I help?”  A very elderly voice on the other end of the line said “Oh, good. A doctor. Finally. I want to ask you about my wife - that’s Mrs. Webster in Room 642.” Jeremy saw one of the other nurses coming. He put his hand over the phone and whispered…..”It seems to be Mr. Webster asking about his wife. Can you  take this call, please? I don’t know how she’s been……..” Taking his hand away from the phone he said “Mr. Webster, I’m going to have you speak with one of the nurses while I look at your wife’s chart.” He quickly passed the phone to the nurse, hoping it was Mrs. Webster’s nurse.

“Webster, Webster…..here it is.” Jeremy picked up her chart to review it again. Once he had done so, he was about to tell the nurse he could speak with the old gentleman, but she was hanging up the phone. “It’s all right Dr. Crawford. He calls every night before he goes to bed. He’s quite a night owl. I’m Jennifer Cartwright. I don’t think we’ve met. Excuse me, but I have to get that bell. Mr. Smith in 639. He’s been a sick sick man, but he’s almost ready for discharge. Getting quite nervous about it.”  And she was gone. Now, where was he? Mrs.Tyler and her belongings. Who is she and why does she have a picture of an Emelina Eliot? 

~~~~~

Mrs. Tyler’s condition was very poor and was deteriorating. Jeremy was at her bedside for the better part of the next two hours. He muttered between clenched teeth…. “She should be in ICU. I don’t have the right equipment and medications here.” Miss Green came in. “Here Dr. Crawford I’ll take over. Go to the nurses station and sit down for a few minutes. I found some paper work in Mrs. Tyler’s belongings. Take a look at those while you’re taking a breather.” Through his tiredness, Jeremy got excited. “Thank you, Miss Green - I’ll do as I’m told and sit down. I'll take a look at the papers to see if there’s anything there - thank you.”  Miss Green looked up from checking an intravenous site in Mrs.Tyler's arm. Over her shoulder she said. “I think one of the papers said something about ‘adoption’.

“We must leave this terrifying place to-morrow 

and go searching for sunshine.”

~ F.Scott Fitzgerald

Unwritten

I have two short pieces of writing this evening. They are from our Writer’s group assignment for the month of April. We create an assignment each month for each of us in our little group. This month we were to write ‘a newspaper article about a famous event in history’. This was a difficult assignment for me, as I am much more used to stream of consciousness writing and creative non-fiction, even for the short pieces I write. There has been so much going on in the world that to choose one was quite overwhelming. Considering Florence Nightingale, I did some brief research, complements of Wikipedia and other online sites, and found an event. If a newspaper was picked up at the time, I couldn’t tell. So I’ve taken the liberty to write it on this blog 164 years later. When I read it aloud this afternoon, I felt it was choppy and did not flow very well at all. Please feel free to comment and critique my efforts.

Original piece:

Hoping for a change to the role of women has been replaced with action by Florence Nightingale. As one of a very few women reporters, I was impressed by this woman of tiny stature when hearing her speak out for women and to receive monies that have allowed her goals to be furthered for women and nursing by the establishment of a training school at St. Thomas Hospital. In 1855, a fund was set up by members of the public to provide money for her very prodigious work. Many reports suggest that she listens more to the counsel of men than woman, however in her own life she has set herself the momentous task to live and serve outside of an often oppressive, and sometimes decorative, role of women. The establishment of the training school is possibly the beginning for a woman’s role to work outside the home because of a calling to serve others, when there has been little encouragement for women to seek higher education or work outside of the home. In the main, women have been supported financially by men. Florence Nightingale has dared to step into roles disapproved of by her own mother and sisters. She has challenged the male dominated medical profession in the simple task of hand washing before surgeries and between patients, demanding cleanliness throughout any hospitals, however humble, for the sick and suffering. Florence Nightingale, a very controversial and authentic figure, accepted the monies with much gratitude for her continuing service to mankind.

Edited piece

Hoping for change has been replaced with action by Florence Nightingale, a woman of tiny stature and pleasant visage. As one of a very few women reporters, I was impressed by her speech and manner when hearing her gracious receipt of the monies that have allowed her goals to be furthered. With the monies, she plans the establishment of a training school at St. Thomas Hospital for women wishing to become deaconesses. Given her in 1855, these monies derived from a fund set up by members of the public to provide money for her very prodigious work. Many less charitable reports suggest that she listens more to the counsel of men than woman so are not in support of releasing women from traditional roles. In her own life she set herself the momentous task to live and serve outside the often oppressive role of women. The establishment of such a training school is possibly the beginning for many women to work outside the home because of a calling to serve others, when there has been little encouragement for women to seek higher education or work outside of the home. In the main, women have been supported financially by men. Florence Nightingale has dared to step into roles disapproved of by her own mother and sisters. She has challenged the male dominated medical profession in the simple task of hand washing before surgeries and between patients, demanding cleanliness throughout any hospitals, however humble, for the sick and suffering. Florence Nightingale, a very controversial figure, accepted the monies with much gratitude for her continuing service to mankind.

“So never lose an opportunity of urging a practical beginning, 

however small, for it is wonderful how often in such matters 

the mustard-seed germinates and roots itself.”

~ Florence Nightingale

Alternative Medicine

Poetry ~ calligraphy from the soul of romance and love,

jazzy storied expressions of life from top hatted crows dipping and diving,

grey skies sodden with sadness

rumbling with grief,

brilliant balloons and soap-bubbles popping with joy and laughter ~

passionate plucking of heartstrings preventing emotional rust and decay.

“There is not a particle of life which does not bear poetry within it.”

~ Gustave Flaubert

A Thank You Note

It was Nurses Week last week. I did not write anything about nurses or honouring nurses. Not even complaining about nursing. But I did work in nursing. At the beginning of this year, going in depth about things - anything - has been a challenge that was laid on my table. The concept of a depth year didn’t originate from me. That would have involved acting on all of the swirling thoughts in my head. It did come from a CBC interview. Mary Hynes, on Tapestry, one Sunday afternoon, interviewed David Cain from Winnipeg about this idea of going in depth. Not buying anything new. This seemed like a great idea. I tend to be really tight with my money - until I’m not. I suppose it is more like thinking about being tight with my money.

So I started with that concept. Not buying anything new. As days and weeks progressed, I began looking at more things in depth, especially my nursing career. My retirement from nursing approaches ever more closely as I turned seventy years old in November of last year. I am still interested in and concerned about nursing. The part of nursing that interests me is the attitude of nursing. It sounds rather flip to talk about caring about and for our patients. Spending time with our patients. Today’s nurses are often instructed and encouraged to use the word ‘clients’. I do believe that this simple wording change moves us away from the attitude of nursing.

I have cared for individuals in most areas of nursing. Nursing in paediatrics and obstetrics have not interested me, but I have experienced the other side of paediatrics as a young teenager and of obstetrics as a young mom. Of course I did work in both areas in my nurse training years. Despite the little exposure in these two fields, I have cared for individuals from 1 1/2 years old to 108 years old. All along this age continuum, each person has required different care, but with the same attitude of nursing. Sick people need to feel safe, emotionally and physically. Each age, each level of ability, and many times each sort of vocabulary used, will involve different lengths of time. This is especially true for the very young, the very old, people new to being ill, chronic illnesses including addiction and mental health, surgical as opposed to medical issues, end of life concerns. Of course there are new moms, again including addiction and mental health concerns. Bedside nursing will require either more or less time involvement. Community referrals, and therefore community nursing, also requires more or less time involvement. In my present employment in Addictions Nursing at the Detox level, our age range is 19 years to over 80 years old. As the age increases, medical issues increase, infirmity increases and maybe also cognition may decrease. Nursing care requires constant shifting into what models of care are effective for each client (there’s that client word). Is this more psychiatric, geriatric, just out of adolescence or someone who is basically healthy? What nutritional issues need to be addressed?

Going in depth about the attitude of nursing has spoken to my inner beliefs and my personal nursing practice. As nurses we are challenged to fit the mold of whatever system we are in, what ever business model is in place, and unfortunately how some in medicine still see the role of nurses. That role is too often a ‘do as you are told’ attitude rather than a collaborative attitude. In any hospital, treatment centre or clinic nurses work in, our attitudes and practices of nursing mesh with best practices, the mission statement from the board room, as well as policies and protocols to provide emotional and physical safety our patients. When they do not mesh, it is a huge challenge for nurses to work with their patients, or clients, in the manner they were trained to and believe in. But we do it. 

We provide skilled, compassionate nursing care without worrying about recognition. On a daily basis. Recognition is not part of a genuine nursing attitude, but it feels so good when it comes. It comes with a hand lettered card saying Thank you. Saying…you saved my life.  Saying….I remember when you walked me through that anxiety attack.  Saying…Thank you for taking care of my daughter ….my son….my dad….my mom.  And so many other sayings each of us, individually or as a group, hear. Little threads outside of the larger health care settings telling us that the nursing practice we do is more important than any political health crises in the news.

Nurses do more than take blood pressures, record data on computers and give medications. We support each individual in the throes of their acute illness, in their abilities to step forward in their own recovery from illness, educate them about individual health care issues. We are not technology, we use technology. We are not secretaries, we do some documentation. We are not specifically pharmaceutically minded, we administer physician ordered medications. We do not formally diagnose our patients, we do recognize signs and symptoms. We save lives and we escort individuals through their final days. We support individuals as they move through a variety of severe diseases and conditions.

I am so very grateful to have worked with so many different nurses and in different areas over the last 50 years. You have each contributed such great depth to this profession! Thank you all for your wisdom, your support and your willingness to spend time and to deeply care for your patients.

“Nursing is an art…It is one of the Fine Arts: 

I had almost said the finest of Fine Arts.”

~ Florence Nightingale

Warming

when the cold goes to the bone

deep into the bone

when the body shivers and shakes

only controlled by will

there is no medicine like

The Blanket Warmer

in nursing I’ve used many tools

to care for

to ease pains,

especially for those in opiate withdrawal

there is no medicine like

The Blanket Warmer

stacks of clean flannel blankets

tucked behind a silver door

temperature set to warm

till the soft fuzzy blankets absorb the heat

becoming the magic medicine from

The Blanket Warmer

wrapping the one shivering cold and helpless

in the soft kind warmth 

a visible softness smiles on the face

while eyes close peacefully

arms pull warmth close, grateful for

The Blanket Warmer

“Hope is like yeast, you know, rising under warmth.”

~ Leif Enger, Peace Like a River

If I Could Help You

A second poem with the title the same as a Leonard Cohen poem:

If I Could Help You

If I could help you

I would learn to say no

I would wait for you to ask

If I could help you 

I would ease your suffering

but only if you told me

'I'm ready to feel better'

If I could help you

I would share my story

so you knew you were not alone

If I could help you 

I would allow you to fall

ready to give you a hand up

when you sensed it was time to stand

If I could help you 

I would make you tea and toast

if tea and toast was medicine enough

If I could help you

I would listen to your story

to learn where the pain had injured your soul

to learn where your faith and strength was hidden

If I could help you

I would.

“People, even more than things, have to be restored, renewed, 

revived, reclaimed, and redeemed. Never throw out anyone.”

~ Audrey Hepburn

Medieval Medicine: Workshop Review

I was so caught up in the beauty of the snow yesterday that I put aside this review until this afternoon. Victoria snow usually doesn’t last long, so I appreciate it’s beauty while being cautious about icy streets and sidewalks. Saturday, before all the snow, I and a friend attended a  full day of learning about Medieval Medicine. I’m not very good at sitting still and haven’t been in full day classes for a very long time.

Facilitated by Hélène Cazes of Medieval Studies and French, this was the 30^th Annual Medieval Workshop, held on the UVic campus, and was well attended. Started in the living room of one of the founders, interest in Medieval issues has grown so that the venue is now in the Bob Wright Centre at the University. The interest has also been such that a core group of attendees have been returning regularly. The workshop will be taking a new form that will be forthcoming.

Galen and Hippocrates, Master Bartholomaeus and The Black Death. The Balsam Tree, no longer found in this world of modernity, was the panacea of the Medieval world. We learned about the beginnings of medicine. In the foyer on Saturday, there was a Library Presentation, a Silent Auction and demonstrations of various medieval tools, including wool carding, weaving and spinning. Jewelry made and crafted after jewelry from Medieval times were on display and for sale. (I did try on several rings, but didn’t buy anything.) After our lunch break and before the afternoon session, we were treated to music by the Banquo Folk Ensemble playing and singing medieval music. They had a varied selection of medieval musical instruments.

Writing this review cannot encompass all that was presented. Was this fun? Not certain I can say that it was. Was it interesting?  Most definitely. Since medieval times, men like Hippocrates and Galen, have grasped onto questions about the nature of healing. Along the way, the identification of diagnosing and differing treatments have brought us into the sphere of modern medicine.

“Wherever the art of medicine is loved, there is also a love of humanity.”

~ Hippocrates

Epilepsy - A Brief Historical Perspective

Hippocrates, known as the father of medicine, in his book The Sacred Disease of 400 B.C., refuted the belief that this hidden and fearful disease of epilepsy had any sacredness at all!

The belief in the sacred or divine nature of epilepsy lasted for many centuries along with other beliefs about epilepsy. Another book, Malleus Maleficarum, a handbook on witch-hunting written by two Dominican friars in 1494, identified the presence of seizures as a characteristic of witches, signing death warrants for many people with such an affliction.

Because of epilepsy’s elegant and varied array of signs and symptoms of voice, movement and behaviour, it would seem that we have been confusing, and frightening people for centuries. So much so that a short list of many names and qualities besides witch and ‘divine‘ is:

    degenerate, idiots and lunatics

    possessed of demons

    an affinity for music and dance

    morally insane and ~ that

    epilepsy was contagious

There have been epilepsy colonies to remove epileptics from society, the last closing as recently as the 1950’s and 1960‘s. We have been dumped, shunned and in general pushed aside as inferior to others. Beliefs are the framework by which individuals and cultures define those things that cannot be understood easily and so culture, belief systems and superficial medical knowledge all contributed to these odd, and in some cases, fatal beliefs.

While we must be careful not to medicalize the human condition, it was a good thing that Hippocrates began this discussion so many centuries ago. As medicine has evolved, learning about the various ways that our brains function, neurology and neurobiology have come to the fore, providing us with diagnosis, medication, and treatment. These medical advances through history, while slow and not without difficulty, have allowed us to take a rightful place within society.

“Men think epilepsy divine, merely because they do not

understand it. But if they called everything divine which they

do not understand, why, there would be no end to divine things.”

~ Hippocrates