Call the Midwife Page 5

  I remember lectures during my Part I midwifery training about the advantages of bottle-feeding, which sounded very convincing. When I first came to work with the Nonnatus Midwives, I thought them very old fashioned in always recommending breastfeeding. I had not taken into account the social conditions in which the Sisters worked. The lecturers were not dealing with real life. They were dealing with classroom situations and ideal young mothers who existed only in the imagination, from educated middle-class backgrounds, women who would remember all the rules, and do everything they were told to do. These classroom pundits were remote from silly young girls who would get the formula mixed up, get the measurements wrong, fail to boil the water, be unable to sterilise the bottles or the teats, fail to wash the bottles. Such theorists could not even imagine a half-empty bottle being left for twenty-four hours, then given to the baby, nor envisage a bottle rolling across the floor, picking up cat hairs, or any other dirt. Our lecturers never mentioned to us the possibility of anything else being added to the formula, such as sugar, honey, rice, treacle, condensed milk, semolina, alcohol, aspirin, Horlicks, Ovaltine. Perhaps such a possibility had never come the way of the writers of these textbooks. But they had been encountered often enough by the Nonnatus nuns.

  Edith and her baby looked quite happy, so I did not disturb them, but said we would call the next day to weigh the baby, and to examine her.

  I had another visit to make, to Molly Pearce, a girl of nineteen who was expecting her third baby and who had not turned up at the antenatal clinic for the last three months. As she was very near to full term, we needed to assess her.

  There was noise coming from inside the door as I approached. It sounded like a row. I’ve always hated any sort of row or scene, and instinctively shrank away. But I had a job to do, so I knocked on the door. Instantly there was silence inside. It lasted a couple of minutes, and the silence seemed more menacing than the noise. I knocked again. Still silence, then a bolt pulled back, and a key turned – it was one of the few times I had known a door to be locked in the East End.

  The unshaven face of a surly looking man stared suspiciously at me through a crack in the door. Then he swore obscenely, and spat on the floor at my feet, and made off down the balcony towards the staircase. The girl came towards me. She looked hot and flushed, and was panting slightly. “Good riddance,” she shouted down the balcony, and kicked the doorpost.

  She looked about nine months pregnant, and it occurred to me that rows of that sort could put her into labour, especially if violence was involved. But I had no evidence of that, as yet. I asked if I could examine her, as she had not been to antenatal clinic. She reluctantly agreed, and let me into the flat.

  The stench inside was overpowering. It was a foul mixture of sweat, urine, faeces, cigarettes, alcohol, paraffin, stale food, sour milk, and unwashed clothes. Obviously Molly was a real slattern. The vast majority of women that I met had a true pride in themselves and their homes, and worked desperately hard. But not Molly. She had no such home-making instincts.

  She led me into the bedroom, which was dark. The bed was filthy. There was no bed linen, just the bare mattress and pillows. Some grey army surplus blankets lay on the bed and a wooden cot stood in the corner. This is no place for a delivery, I thought to myself. It had been assessed as adequate by a midwife some months earlier, but quite obviously the domestic conditions had deteriorated since that time. I would have to report back to the Sisters.

  I asked Molly to loosen her clothes and lie down. As she did so, I noticed a great black bruise on her chest. I enquired how it had happened. She snarled and tossed her head. “‘Im,” she said, and spat on the floor. She offered no other information, and lay down. Perhaps my unexpected arrival has saved her from another blow, I thought.

  I examined her. The baby’s head was well down, the position seemed to be normal, and I could feel movement. I listened for the foetal heart, which was a steady 126 per minute. She and the baby seemed quite normal and healthy, in spite of everything.

  It was only then that I noticed the children. I heard something in the corner of the dark bedroom, and nearly jumped out of my skin. I thought it was a rat. I focused my eyes in that direction, and saw two little faces peering round from behind a chair. Molly heard my gasp, and said, “It’s all right. Tom, come ‘ere.”

  But, of course, there must be young children around, I thought. This was her third pregnancy, and she was only nineteen, so they would be under school age. Why hadn’t I noticed them before?

  Two little boys of about two or three years old came out from behind the chair. They were absolutely silent. Boys of that age usually rush around, making no end of noise, but not these two. Their silence was unnatural. They had big eyes, full of fear, and they took a step or two forward, then clung to each other as though for mutual protection and retreated behind the chair again.

  “That’s all right, kids, it’s only the nurse. She won’t hurt you. Come ‘ere.”

  They came out again, two dirty little boys, with snot and tear marks staining their faces. They were wearing only jumpers, a practice I had seen a lot in Poplar, and for some reason I found it particularly repellent. A toddler was dressed only at the top, and left naked from the waist down. It seemed to be especially prevalent among little boys. I was told that the women saved on washing this way. The child, before he was toilet trained, could then just urinate anywhere, and there would be no nappies or clothes to wash. Children would run around the tenement balconies and courtyards all day like this.

  Tom and his little brother crept out from the corner, and ran to their mother. They seemed to be losing their fear. She put out an arm affectionately and they cuddled up to her. Well at least she’s got some mothering instincts, I thought. I wondered how much time those little children spent behind the chair when their father was at home.

  But I was not a health visitor, nor a social worker, and there was no point in speculating on that sort of thing. I resolved to report my observations to the Sisters, and told Molly that we would come back later that week, to ascertain that everything was available for a home delivery.

  I still had Muriel to visit, and it was with great relief that I left the foul atmosphere of that flat.

  The bright cold air outside and the cycle ride down to the Isle of Dogs refreshed my spirits, and I sped along.

  “Hello, luvvy, how’s yourself?” was the greeting shouted at me by several women, known and unknown to me. This was always the greeting called out from the pavement. “Lovely, thanks, ah’s yerself?” I always replied. It was difficult not to slip into the cockney lingo.

  I don’t believe it, I said to myself, as I turned into Muriel’s street, she can’t be here already. Sure enough, Mrs Jenkins was there with her stick and her string bag, her head scarf over her curlers, and the same old long mildew-encrusted coat that she wore summer and winter. She was talking to a woman in the street, hanging intently on to every word. She saw me slow down and came up to me and grabbed my sleeve with her filthy, long nailed hands.

  “How is she, and the little one?” she rasped.

  I was impatient, and pulled my arm away. Mrs Jenkins turned up at every delivery. No matter how far the distance, how bad the weather, how early or late in the day, Mrs Jenkins would always be seen hanging around the street. No one knew where she lived, or how she got her information, or how she managed to walk, sometimes three or four miles, to a house where a baby had been born. But she always did.

  I was irritated and passed her without speaking. I regarded her as a nosy old busybody. I was young, too young to understand. Too young to see the pain in her eyes, or to hear the tortured urgency in her voice.

  “‘Ow is she? An’ ve li’l one. ‘Ow’s ve li’l one?”

  I went directly into the house without even knocking, and Muriel’s mother immediately came forward, busy and smiling. These older generation mothers knew that they were absolutely indispensable at times like these, and it gave them a great sense of fulfilmen
t, an ongoing purpose in life. She was all bustle and information. “She’s been asleep since you left. She’s been to the toilet and passed water. She’s had some tea and now I’m getting her a nice bit of fish. Baby’s been to the breast, I’ve seen to that, but she aint got no milk yet.”

  I thanked her and went up to the room. It looked clean, fresh and bright, with flowers on the chest of drawers. Compared to the filth and squalor of Molly’s flat, it looked like paradise.

  Muriel was awake but sleepy. Her first words to me were, “I don’t want no fish. Can’t you tell mum that? I don’t feel like it, but she won’t listen to me. She might listen to you.”

  Clearly there was a difference of opinion between mother and daughter. I did not want to be involved. I checked her pulse and blood pressure – normal. Her vaginal discharge was not excessive; the uterus felt normal too. I checked her breasts. A little colostrum was coming out but no milk, as her mother had said. I wanted to try to get the baby to feed, in fact that was the main purpose of my visit.

  In the cot the baby was sleeping soundly. Gone was the puckered appearance, the discoloration of the skin from the stress and trauma of birth, the cries of alarm and fear at entering this world. He was relaxed and warm and peaceful. Nearly everyone will say that seeing a newborn baby has an effect on them, ranging from awe to astonishment. The helplessness of the newborn human infant has always made an impression on me. All other mammals have a certain amount of autonomy at birth. Many animals, within an hour or two of birth, are up on their feet and running. Others, at the very least, can find the nipple and suck. But the human baby can’t even do that. If the nipple or teat is not actually placed in the baby’s mouth and sucking encouraged, the baby would die of starvation. I have a theory that all human babies are born prematurely. Given the human life span – three score years and ten – to be comparable with other animals of similar longevity, human gestation should be about two years. But the human head is so big by the age of two that no woman could deliver it. So our babies are born prematurely, in a state of utter helplessness.

  I lifted the tiny creature from his cot and brought him to Muriel. She knew what to do, and had started squeezing a little colostrum from the nipple. We tried brushing a little of this over the baby’s lips. He was not interested, only squirmed and turned his head away. We tried again, with the same reaction. It took at least a quarter of an hour of patiently trying to encourage the baby, but eventually, we persuaded him to open his mouth sufficiently to insert the nipple. He took about three sucks, and went off to sleep again. Sound asleep, as though exhausted from all his efforts. Muriel and I laughed.

  “You would think he’d been doing all the hard work,” she said, “not you and me, eh, nurse?”

  We agreed to leave it for the time being. I would be back again in the evening, and she could try again during the afternoon, if she wanted to.

  As I went downstairs, I smelt cooking. It may not have been to Muriel’s liking, but it certainly got my gastric juices going. I was starving, and a delicious lunch awaited me at Nonnatus House. I bade them goodbye, and made for my bicycle. Mrs Jenkins was standing over it, as though she were keeping guard. How am I going to get rid of her? I thought. I didn’t want to talk. I just wanted to get back to my lunch, but she was hanging on to the saddle. Clearly she was not going to let me go without some information.

  “‘Ow is she? An’ ve li’l one. ‘Ow’s ve li’l one?” she hissed at me, her eyes unblinking.

  There is something about obsessive behaviour that is off-putting. Mrs Jenkins was more than that. She was repellent. About seventy, she was tiny and bent, and her black eyes penetrated me, shattering any pleasant thoughts of lunch. She was toothless and ugly, in my arrogant opinion, and her filthy claw-like hands were creeping down my sleeve, getting unpleasantly close to my wrists. I pulled myself to my full height, which was nearly twice hers, and said in a cold professional voice, “Mrs Smith has been safely delivered of a little boy. Mother and baby are both well. Now, if you will excuse me, I must go.”

  “Fank Gawd,” she said, and released my coat sleeve and my bicycle. She said nothing else.

  Crazy old thing, I thought crossly as I rode off. She ought not to be allowed out.

  It was not until about a year later, when I was a general district nurse, that I learned more about Mrs Jenkins…and learned a little humility.

  CHUMMY

  The first time I saw Camilla Fortescue-Cholmeley-Browne (“just call me Chummy”), I thought it was a bloke in drag. Six foot two inches tall, with shoulders like a front-row forward and size eleven feet, her parents had spent a fortune trying to make her more feminine, but to no effect.

  Chummy and I were new together, and she arrived the morning after the memorable evening when Sister Monica Joan and I had polished off a cake intended for twelve. Cynthia, Trixie and I were leaving the kitchen after breakfast when the front doorbell rang, and this giant in skirts entered. She blinked short-sightedly down at us from behind thick, steel-rimmed glasses, and said, in the plummiest voice imaginable, “Is this Nonnatus House?”

  Trixie, who had a waspish tongue, looked out of the door into the street. “Is there anyone there?” she called, and came back into the hallway, bumping into the stranger.

  “Oh, sorry, I didn’t notice you,” she said, and made off for the clinical room.

  Cynthia stepped forward, and greeted the woman with the same exquisite warmth and friendliness that had chased away my thoughts of bolting the night before. “You must be Camilla.”

  “Oh, just call me Chummy.”

  “All right then Chummy, come in and we will find Sister Julienne. Have you had breakfast? I’m sure Mrs B. can fix you up with something.”

  Chummy picked up her case, took two steps, and tripped over the doormat. “Oh lawks, clumsy me,” she said with a girlish giggle. She bent down to straighten the mat and collided with the hallstand, knocking two coats and three hats on to the floor.

  “Frightfully sorry. I’ll soon get them,” but Cynthia had already picked them up, fearing the worst.

  “Oh thanks, old bean,” said Chummy, with a “haw-haw”.

  Can this be real, or is she putting it on? I thought. But the voice was entirely real, and never changed, nor did the language. It was always “good show”, or “good egg”, or “what-ho”, and, strangely enough, for all her massive size, her voice was soft and sweet. In fact, during the time that I knew her, I realised that everything about Chummy was soft and sweet. Despite her appearance, there was nothing butch about her. She had the nature of a gentle, artless young girl, diffident and shy. She was also pathetically eager to be liked.

  The Fortescue-Cholmeley-Brownes were top drawer County types. Her great-great-grandfather had entered the Indian civil service in the 1820s, and the tradition had progressed through the generations. Her father was Governor of Rajasthan (an area the size of Wales), which he still, even in the 1950s, traversed on horseback. All this we learned from the collection of photographs on display in Chummy’s room. She was the only girl amongst six brothers. All of them were tall, but unfortunately she was about an inch taller than the rest of the family.

  All the children had been educated in England, the boys going to Eton, and Chummy to Roedean. They were placed in the care of guardians in this country, as the mother remained in India with her husband. Apparently Chummy had been at boarding school since she was six years of age, and knew no other life. She clung to her collection of family photographs with touching fervour – perhaps they were the closest she ever got to her family – and particularly loved one taken with her mother when she was about fourteen.

  “That was the holiday I had with Mater,” she said proudly, completely unaware of the pathos of her remark.

  After Roedean came finishing school in Switzerland, then back to London to the Lucy Clayton Charm School to prepare her for presentation at Court. Those were the days of debutantes, when the daughters of the “best” families had to “come out”, an expr
ession meaning something quite different today. At that time it meant being presented formally to the monarch at Buckingham Palace. Chummy was presented and two photographs were proof of the event. In the first, an unmistakable Chummy in a ridiculous lacey ball gown, with ribbons and flowers, stood amongst a group of pretty young girls similarly attired, her huge, bony shoulders towering above their heads. The second photo was of her presentation to King George VI. Her great size and angular shape emphasised the petite charm of the Queen and the exquisite beauty of the two princesses, Elizabeth and Margaret. I wondered if Chummy was aware of how absurd she looked in the photos, which she was so pleased and so happy to display.

  After the debutante bit came a year at a cordon-bleu school which took a small number of select young ladies on a residential basis. Chummy learned all the arts of the perfect hostess – the perfect hors d’oeuvre, the perfect pàté de foie gras – but remained ungainly, awkward, oversized, and generally unsuited to hostessing in any society. So a course of study at the best needlework school in London was deemed to be the right thing for her. For two years Chummy crocheted, embroidered and tatted, made lace and quilting and broderie anglaise. For two years she machined and set shoulders and double hemmed. All to no avail. While the other girls herringboned and feather-stitched and chatted happily, or sadly, of their boyfriends and lovers, Chummy, liked by all but loved by none, remained silent, always the odd chum out.

  She never knew how it happened, but suddenly, unsought, she found her vocation: nursing and God. Chummy was going to be a missionary.