In Falling Snow (32 page)

Dugald came back in a long grey coat and wide-brimmed hat. As we came out into the day, which had turned sullen, he grabbed my arm and slid it into his and said, “It won't rain, not while you're here. Let's take the park.” We went to the Luxembourg Gardens. A group of old men played
pétanque
on the grass and one of them called hello to Dugald, who took his arm out of mine and waved back. We went down to the little lake where boys sailed boats and sat awhile to watch. Dugald said he'd sailed boats like these with his grandfather as a boy.

As we walked again, Dugald asked me how Miss Ivens was. I told him she was well, on my guard given the questions he'd asked during his visit. He sensed my reluctance. “I know this is a delicate matter,” he said. “But we have had a complaint about your Miss Ivens, about her surgical practice.”

“Dr. McCourt,” I said.

“Of course, I cannot say but I need to know, Iris. If we get a complaint from a senior surgeon, we must assure ourselves. You know Miss Ivens better than anyone at the hospital. I know this is unfair but you must tell me, for the sake of the men, if there is a problem.”

I thought of the day Miss Ivens dressed up as a bear for one of our pageants, jumping across the stage, the patients in fits of laughter. I thought of her with the little Senegalese boy in our first days as a hospital, easing his passage to the other side, her voice when she addressed him, so kindly. I thought of a note we'd received just that week from a lad whose arm she'd saved,
Mon colonelle
, the patients called Miss Ivens
, I can write this because of you, and I thank you from the bottom of my heart
. I thought of her standing in front of us all, telling us we'd failed the first inspection and needed now to rally, her brave face, her meddling with anything to do with running the abbey, driving us all to distraction. “On my honour, Dr. McTaggart, Miss Ivens is truly the finest human being I have ever known and as every patient or doctor you speak to at Royaumont would tell you, she is a great surgeon.”

“Thank you, Iris. It is as I thought it would be. But I needed to be sure. I know you would tell me the truth.”

I felt strangely guilty, as if I'd lied to him, which I hadn't, although I had often thought about Dr. McCourt since her departure. She was angry with me for doing what she thought a nurse shouldn't be doing. And she was right. None of the other nurses would have been changing a dressing as complex as that. And she had been worried enough about Miss Ivens's actions to question her in the theatre, which she must have known would lead to trouble. Who was I to know whether any particular course of action in surgery would be efficacious? I dismissed these thoughts. Whatever errors Miss Ivens might have made, she was everything I'd told Dugald and more.

We found a seat among the trees. Dugald motioned me to sit and sat down next to me. “Enough on the hospital. Let us speak of more important matters.” He put his arm over the seat behind me. I did nothing to stop him. “Time is against us,” he said. “The war makes me bold. Iris, I have thought of nothing but you since we met up again. I have hardly been able to write my report.” He leaned in towards me and took my hand in his and I felt a charge.

I had thought of Dugald too but I didn't say so. I also didn't say that I was engaged. I didn't mention Al at all. I sat on the bench and let Dugald kiss me full on the mouth. I looked up at the big fat wet leaves of the elm trees, the grey sky above them, and felt my heart would burst. Was this love? Was this what love would feel like? I could smell something sweet like perfume on Dugald's cheeks, feel the roughness of his beard. When he withdrew from the kiss, I could see in his eyes—they looked like fire—that he felt it too. I had a sudden feeling of foreboding that I didn't understand and that I dismissed.

A soft rain started to fall. I didn't think to say to Dugald that he'd been wrong. The rain hadn't held off at all.

Two days later his report arrived and it was an “excellent document” according to Miss Ivens. I could feel myself blushing as she read from it. “Whatever is the matter, Iris? You're flushed to the ears.”

“Nothing. I think I've just been too busy. It's nothing, really.”

“How odd.” She went on reading.

Violet sat beside her, grinning and looking at me. I tried to give her a look to make her stop.

“This is by far the best report we've ever had,” Miss Ivens said. “I don't know what you told him, Iris, but you're going to show the auditors round from now on.”

“That's a terrific idea, Frances,” Violet said. “Iris certainly seems to have the touch.” She smiled sweetly at Miss Ivens.

“Quite,” Miss Ivens said. “It's champagne for all this evening. Iris, you are worth your weight in gold.”

“Gold,” Violet repeated, a stupid smile on her face. I glared at her.

Dugald had commended the hospital for its achievements while making sure Michelet could stay on for the duration as our cook. Quoyle had been a little miffed to lose her position but happy once Miss Ivens told her she'd be working in the central office with me. Miss Ivens was not a good organiser and seemed to lose everything she touched. Quoyle had a way of watching where Miss Ivens put things and always being able to locate them. It made the office run much more smoothly.

Michelet had begun to tend the abbey vegetable gardens. We'd always produced as much of our own food as possible but Michelet understood the soil and climate in a way none of us did. He resurrected the abbey orchards, pruning trees and telling us we would soon have wonderful fruits. He put away preserves and even planted flowers for the spring and summer. The hens started laying again under his care, and he bought pigs and goats, which were easier to explain to Edinburgh than I thought they would be. He really was a marvel and we were lucky to have him. Having said that, he didn't come without difficulties.

When Michelet took over the abbey kitchen, we had trouble finding kitchen hands who would work with him. We lost two good girls in as many weeks. He wasn't temperamental exactly, but he was particular about the way food had to be prepared. Miss Ivens was always ready to forgive him whenever staff complained. And I supported her in this, for Michelet was wonderful with the patients, sitting with them at mealtimes, feeding those who couldn't feed themselves if he had time, giving them wine from his own cellar. He never baulked at a request for a meal for the many hungry soldiers who passed the abbey and he always participated happily in our celebrations, turkeys at Christmas, cakes for our ward parties, special meals for other occasions. In the evenings after the dinner was prepared I would often go into the kitchen and find him sitting at the window playing a tune on his little flute. Sometimes Violet would be there with him, drinking wine, and she'd sing a song. Other evenings, I'd see Michelet coming from the forest, his jacket bulky, and when I asked he'd show me a pheasant or two he'd shot to cook up for the doctors.

But the kitchen hands who'd worked with Quoyle through the first few years couldn't abide Michelet. They got into a scrape over the kitchen floor of all things. They said Michelet was messy and they wouldn't wash the kitchen floor for him. According to one of the girls, Michelet responded by spreading grease all over the floor and threatening to leave the floor in that state for Miss Ivens to see. Eventually Miss Ivens herself intervened. She sent Michelet away for a break—he'd been working intensively to re-establish the kitchen, the gardens, the animals, the supply room, and he was exhausted. But then the kitchen hands refused to run the kitchen in his absence so Miss Ivens dismissed them and brought Michelet back and found new people. He was happy with the outcome and so was Miss Ivens, who never liked the kitchen hands much anyway. “Most of them have no idea how to cook meat,” Miss Ivens said. “Michelet cooks meat splendidly.”

Violet said Michelet and Miss Ivens were alike. “They're both skilled and arrogant and hard on everyone around them except the weak. I agree he's wonderful with the patients but kitchen hands are a whole different matter. They're in his zone of expertise so he expects them to respect that. When they don't do things the way he does them, it drives him crazy. And for most of them, this has been the one thing in their lives they've been allowed to run, a kitchen, and here, a man is telling them what to do, shouting when they don't do it the way he wants them to, and getting away with it.”

“Miss Ivens isn't like Michelet,” I said to Violet. “She's never been angry with me.”

“But you're not in her zone.”

“Yes I am. We work in the same room.”

“But you're not a surgeon. That's her zone. Administration, that's your zone and she knows it. But if you were a surgeon, you'd have to do what she says.”

“The doctors love Miss Ivens.”

“The doctors know better than to cross her.” I thought of Dr. McCourt.

The other recommendation of Dugald's report was that the Scottish Women's Hospitals and Miss Ivens in particular be asked to supervise another hospital. We'd known for some time that the French wanted to open a centre closer to the front in order to treat injuries nearer where they occurred. It had become obvious that the original practice of “resting” an injured soldier before surgery was a recipe for death, giving infection time to take hold. We'd heard talk of the plan for another closer hospital in our zone but didn't think we were to be involved.

As a result of Dugald's report, the committee in Edinburgh, reassured about Miss Ivens's excellent management ability, with just a minor concern about her lack of thrift, had agreed to the proposal that
les dames écossaises
should set up a sister hospital. We would locate a site closer to the fighting that could function as something more than a casualty clearing station but less than an operating hospital.

Royaumont had continued to remain quiet during that first half of 1917—the fighting was to the north of us—and we were glad to have a new project to work on. I went with Miss Ivens to find the best location. We visited the abbey in Soissons, on the grounds that our abbey was an ideal hospital, but the abbey at Soissons had been too badly damaged by shelling. Similarly, we inspected a large house gifted by a French family and ruled it out. We settled upon an old evacuation centre made up of timber huts at Villers-Cotterêts, forty miles from Royaumont, right on the railway line and only twelve miles from the front. And then we set about creating another hospital for France.

When she arrived at work, there was a message from Ian Gibson's office to say they could fit Henry in early the following week. She called David. “Good,” he said. “You're probably right and it's nothing but at least we'll know.” That morning at home, Grace had looked over at her small son, sitting on the floor playing with his tip truck. He was tired even though he'd only recently woken from a night's sleep. It wouldn't be nothing, Grace already knew, but hopefully it would be something they could deal with.

David had left early for the hospital and she still hadn't had a chance to tell him about the incident with Jennifer Wilson. “I have to talk to you about something that happened here at work,” she said now. “Can we meet for a coffee?”

“Give me fifteen to finish up here,” he said. “Ground floor?”

They met in the hospital cafeteria. David ordered coffees and a Danish for himself. Grace wasn't hungry.

He sat down across from her. “I don't know how to say this,” Grace said. “I made an error.”

“The Wilson baby,” he said matter-of-factly, biting into the Danish.

“How do you know?”

He chewed and swallowed. “I work here. Clive Markwell is telling everyone but me that you can't follow protocols. This is the man who induces labour for every woman under his care just before he goes on holidays. Not exactly protocol, that. But let's not worry about him. He thinks he's just fine.”

“But I saw the woman the day before. Her blood pressure was up. I should have admitted her.”

“For goodness' sake, Grace, any other clinician might have done exactly as you did.”

“I knew her when I was at school, David. We had some history. I should have found someone else to examine her.”

“Did you offer her the opportunity to see another doc?”

“She didn't want to.”

“Well, that's her choice. You know as well as I do you can't just run and get another doctor. We're all too busy to have the luxury of worrying about personal histories.”

“But it did worry me. I think I should have seen it,” Grace said.

He grabbed her hand. “Hindsight's a great way to punish yourself, Grace. I've got enough real idiots to deal with. I gotta go.” He kissed her on the cheek and got up. Halfway to the elevator he turned around. “You're just my amazing Grace. I wish you knew it.”

She couldn't help but smile. She wasn't sure what she'd expected when she told David but it hadn't been this. He was such a good clinician himself, careful, meticulous. Grace had thought he would see this as her fault. And yet, he hadn't. She gathered up his coffee cup, half drunk, his Danish, half eaten, and threw them in the bin on her way down the corridor.

She stopped by the medical library to pick up the clippings Katie had left for her at the desk. In the photo, Violet Heron was a sparrow of a woman, bent over with age, snow-haired but with fierce eyes. She wore a beret on her head and large glasses. She looked familiar and Grace thought she might have been one of the women pioneers in medicine they'd studied in med school. Most of them were British, starting with Sophia Jex-Blake, who'd had such a difficult time of it that she'd started her own medical school for women.

We have no mercy for these men
, Violet Heron was quoted as saying.
We will find them out, make their dirty secrets public, and care for their sisters and daughters whose lives have been irreparably damaged, whose bodies and minds bear the scars of what these men have done
. Grace could see what Katie had meant. Violet Heron was certainly out there, unconventional, and completely unexpected as someone who would have been friends with Iris, who'd always been so proper about everything. Iris had this saying. Whenever someone upset Grace, Iris would say you never knew people. “You never know people. Don't forget that, Grace.” Now, it seemed, it was Iris herself Grace didn't know.

When she got back to the ward, the director of obstetrics was there. “Can we go to my office?” Rob Ingram said curtly.

They took the elevator back down to the third floor. Although they were alone, he spent the trip in silence, staring at the numbers above them. They walked along the corridor, again in silence, and when they arrived at his office Rob gestured to Grace to sit and sat opposite her.

He put his hands together as if in prayer before he spoke. “I've had a complaint from a senior clinician . . .”—he frowned slightly as if he didn't quite understand what he'd just said—“. . . who says you went against his direct instructions in relation to one of his patients.”

Clive Markwell had complained about the girl from the hostel Grace had given pain relief. “I did,” Grace said.

“Why?” Rob Ingram said, looking as if he wished Grace had lied instead of telling him the truth.

“Well, if I'm right and it's Dr. Markwell, he wouldn't authorise pain relief for a patient who needed it.”

“He says she didn't want pain relief.”

“I was with the patient at the time, Rob. He was at home.”

“I'm sure he had good reason . . .”

“Punishment. That was his good reason.”

Rob Ingram looked at his desk. “And now he's saying you failed to follow protocols in relation to a suspected pre-eclampsia. This is the Wilson baby.” He shook his head slowly. “Terrible thing, Grace.”

“I'm very aware of what happened, Rob. And yes, I wish I'd admitted the woman the day before. In hindsight, that's what I'd have done.”

“Good. Well, we'll have to set up a panel to investigate all this now.” He smiled weakly, tilted his chair forward, found a pack of cigarettes on the desk, and lit one up. He inhaled deeply, then looked at Grace and shook his head. “I don't like these things any more than you do, Grace. We'll get it over and done with as quickly as we can. I just wish it wasn't . . .” He sighed. “I mean, you don't help yourself, Grace.” He tapped ash into the ashtray. “It wouldn't hurt you to be a bit kinder.”

“To whom?”

“Senior clinicians, the junior staff. I've had a couple of complaints about the way you speak to some of the registrars.”

Michael Mastin. “Who's complained?” He sighed again and stood up. “I'm just telling you, Grace. It wouldn't kill you to be nice to people.” Grace noticed he was developing a paunch that hung over a tight belt. “Thanks for coming in.”

Grace called David as soon as she got back to the ward. “The vultures are circling,” he said. He sounded as if he thought it was funny.

“David, they're setting up an external panel.”

“They have to do that now that Clive's complained. I wouldn't lose sleep. Any clinician worth their salt will see it the way I did. I can talk to Rob if you want.”

“No,” Grace said. “I don't want that.” David was more senior than Grace in the hospital. She'd never let him speak for her.

“Well, maybe give Pat Barton a call.”

“You think I need advice?” Grace started to feel frightened.

“No, I didn't say that. But if you're worried, just call Pat and ask him what you ought to do. Sorry, love, I have to go. I'll be late,” he said. “Love you.”

The next day was Friday and she rose early to meet Janis Kennedy. They ran together once or twice a week as their schedules allowed, from the university around the river and back up through the campus to finish at Chez Tessa on Hawken Drive for breakfast.

Janis had been a few years ahead of Grace in med school. They'd met at a women-in-medicine meet-and-greet in Grace's first year and had been friends ever since. Janis was older by ten years—she'd started medicine as a young mother—and she'd helped Grace when Grace had babies and was struggling to maintain her career. Janis had been with David in saying that Iris should continue to live independently after they sold Sunnyside. And when Janis's only son died following an overdose, it was Grace who held her friend as sobs racked Janis's tiny body. “Psychiatrists' mothering,” Janis had said to Grace bitterly the day of the funeral. “Fucked like plumbers' pipes and builders' houses.” The loss had punctuated her life since. She was tougher but also somehow softened, Grace knew.

Grace had told Janis about Jennifer Wilson, said she felt responsible for the baby's death. “I made a mistake.”

Janis stopped running and put a hand on Grace's arm to pull her up. She bent over to catch her breath. Then she said, “You probably did. But it wasn't the first and it won't be the last. We make mistakes.” Janis narrowed her eyes. “When Ryan killed himself, I knew it was my fault. Of course it was. Everybody said it wasn't but I knew.”

“It wasn't your fault.”

“Okay, keep that thought in your mind and then look at your situation. It wasn't your fault.” She started up running again. “Anyway, David's wrong. It's not a lawyer you need. It's a dick.”

“What do you mean?”

“They're doing this because you're a woman, because you're a woman and you're strong. If you were a man, they'd say you're doing great and well done for taking on someone like Clive Markwell, but because you're a woman, and they don't like women anyway, let alone women who have opinions, women who have the audacity to be doctors, and because they know most of their sex feel the same, they're not afraid to express it, they're after you.”

“What do you suggest?”

“Change sex or discipline. I can't recommend being a bloke, but I can recommend psychiatry as a discipline.”

“I'm not sure I fit the profile for psych,” Grace said.

“Because you don't have bad enough taste in ties or because you lack a sustainable neurosis?”

“Neither. Both. Seriously, I don't agree this is sexism,” Grace said. They ran more slowly now. Grace had been so worked up she'd been sprinting, she realised.

Janis had become stronger on feminist politics as she'd got older and she and Grace often argued now. Grace had always been of the view that female doctors just needed to be better than the males. Her own experience had been that her colleagues had mostly welcomed her as an equal once they realised she was there to stay and good at her job. Sure there were doctors like Clive Markwell, but Grace was certain there were fewer of them. In Grace's mind the problem wasn't men so much as biology. Women bore children and breast-fed them. They were in a unique position to care for them. It took them away from their careers in the years they'd get crucial experience. Nothing would change that as far as Grace could see. She had no time for medical students and junior doctors who complained. You have to learn to succeed regardless, she told them. You have to be tough. You have to be better than them. In her own career, Grace had managed as best she could. Many of her colleagues, even one or two of the males, had covered for her when the children were sick, as she had for them, and David took responsibility for the children more than most husbands. “This isn't the whole profession against me,” she said to Janis. “It's just one difficult clinician, a man who will never be any different.”