CHAPTER XXVIII
By resignation of the resident physician, Dr. Zakrzewska is obliged to resume entire charge of Hospital and Dispensary and she again shows symptoms of overfatigue and strain while awaiting Dr. Sewall’s return from Europe to fill the vacant position—Illustrations of the application of Dr. Zakrzewska’s humanitarian instincts and intellectual convictions to the treatment of her patients, in addition to technical medical care—“A Lesson”—“Another True Story.” (1863.)
As Dr. Sewall accepted the offer of the position of resident physician at the Hospital, to take effect on her return from Europe in September, Dr. Zakrzewska continued to fill the duties of this position both at the Hospital and on the two added days in the Dispensary.
The most robust health and endurance have their limits, and she has already been noted as giving many symptoms which showed that she had been presuming on hers ever since the over-strenuous days of establishing the New York Infirmary. Repeated notes of overfatigue and strain creep into these letters to Dr. Sewall.
Specializing largely, as she did, in that branch of medicine (obstetrics) which is most regardless of convenience and most inconsiderate as to sleeping hours, she worked literally day and night. And feeling the whole burden of responding to the demand for the trained woman physician which she had so largely helped in awakening, she refused no patients.
Her humanitarian instincts and her admirable ability to enter into the feelings of her patients, and to recognize their limitations and their struggles, prompted her to send no bills until they were asked for. She writes:
If you could see my office day after day full of school-teachers, dressmakers, mill operatives and domestics, all too proud to go to the dispensary and yet not rich enough to pay a large fee, you would agree with me that the prescription for good meat, wine or beer would be a farce if I took the money with which they ought to buy these instead of taking the small fee which allows them to keep their self-respect.
Not content with reducing her fees to a minimum or to zero, she always added the constructive work which from her point of view belonged within the province of her profession. This was not done by giving charity regarding which she had definite and very modern views. She writes:
It is not Charity which we must cultivate and practice: it is Justice to one another. Charity is what an opiate is to a patient: it soothes for the time but the same bad consequences result as follow the drug. We must teach ourselves that the Golden Rule must be actually practiced in order to reach and raise those who need to be helped.
And again she emphasizes:
The Golden Rule must be practiced every day and not merely formulated as a pious recital on Sunday.
Investigating the routine of the patient’s life, she would help her to reorganize it along the lines of hygiene, of economics, and of a balanced perspective; and then would follow a reëducation not only of the patient but of the patient’s family and even friends. In this way, her influence extended to the men of the family and of the community. And these vied with the women in acknowledging their indebtedness to what they called her “common sense.”
She depicts this aspect of her work so clearly in a couple of sketches written in later years that they are inserted here to add to the definiteness of the outlines of this phase of her history. The first of these (Souvenir of the New England Hospital Fair, 1896) is:
A Lesson
I will a round unvarnish’d tale deliver.
—Shakespeare.
Mary was the third child of five in a family in humble circumstances. The father, an industrious journeyman carpenter, aided by the thrifty mother, managed to keep all the children in attendance at the free public schools of Boston until they graduated at the age of about fifteen years. Soon after leaving school, Mary obtained a situation as child’s nurse in the house of a rich family, with whom she remained nine years in the varying capacity of nursemaid, chambermaid and seamstress. She then married a journeyman plumber twenty-six years of age, he being thus two years her senior. He had laid by from his earnings a sum of money about equal to what Mary had saved from her nine years’ wages, and these combined were amply sufficient to set them up in respectable housekeeping in a neatly furnished tenement having a kitchen, dining-room, living room and chamber, also a storeroom and bathroom.
In due time, the baby made its appearance and found awaiting it a handsome cradle, and a wardrobe not only comfortable but pretty and plentiful. The young father with no small pride carried his son and heir, arrayed in a white cashmere cloak and suitable belongings, while by his side walked his prettily dressed wife, when on Sunday afternoons they went to visit friends and relatives. Thus far, all was well.
After the lapse of five years and a half, four little ones formed the pride and the care of these young folks; and it was just seven years from the time of their marriage that I first entered their home as visiting doctor from the dispensary, the indigent being attended at their homes when illness prevented their coming to the free dispensary at the clinic hours.
I found the family of six living in two rooms heated by the kitchen stove. The children were ill with scarlatina. All around was the evidence of poverty, although not destitution nor degrading squalor. By observation and subsequent inquiry, I soon learned the cause of this changed condition. It was simply this—Mary, who had gradually adapted herself with grace and intelligence to the comforts of the rich house in which she had lived from her fifteenth to her twenty-fourth year, could not now conform herself to the smaller means and ways of living of a wife and mother in moderate circumstances.
She had learned to cook delicate, expensive viands, had a sure belief that tenderloin is the only steak fit for eating, and had great skill in the pretty and dainty ornamentation of the babies. These tastes which she acquired in the rich merchant’s family could not be gratified with the workman’s means; she had unlearned the thrifty habits among which she had lived as a schoolgirl in her parents’ home and she became confused in her methods of work, while the steady increase in her family reduced her in strength and added to her cares and labors, a condition not inclined to promote the good temper of the naturally amiable woman.
Ofter now, the husband, returning home from his work, found no table laid for dinner, and still oftener must he start out early in the morning to find a breakfast in a neighboring eating house, which is always the first step towards finding rest and companionship in the saloon.
This was the condition as it unfolded itself to me during my brief attendance. The children recovered, and with the aid of cod-liver oil and tonics provided by the charity of the dispensary, soon regained full health.
A little more than a year passed when one day in October, 1876, Mary presented herself in my private consulting room. She looked haggard and pale, was poorly clad and in a desperate frame of mind. Her husband had gone from bad to worse. He paid the rent for two shabby small rooms in an old house and provided weekly the coal for the kitchen stove. All the rest of his earnings he spent for his own meals. Often, if he came home at all at night, it was in a state of partial intoxication. Naturally, no firm dared give him regular employment and he supported himself by odd jobs.
The poor woman had resorted to needlework for support, this being the only means for her to earn money and look after her children, whom she could not send to school for lack of shoes and decent clothing.
It was Friday afternoon. She had just carried her work to her employer and received her pay of one dollar and sixty cents. She laid it on the table before me and said, “This is all I with my four children shall have to buy food with until next Friday—it is not enough to buy even bread and tea and that is all we have lived upon for the last three weeks.” She looked wan and hungry and cried bitterly. I sent for a little luncheon, and while she ate it, I devised the following plan:
“Mrs. S——,” said I, “take this money and spend it as follows:
Buy 7 lbs. corned beef $0.35 21 ” potatoes .25 14 ” cabbage .28 7 ” Indian meal .21 1 qt. molasses .15 7 loaves bread .35 Salt .01 $1.60 “Boil the meat in twelve quarts of water until very tender. Divide the meat and broth in seven parts, also the potatoes and cabbage. Cook one portion of cabbage and potatoes each day in the portion of broth. Divide this stew into five equal parts for you and your four children. Do the same with the Indian meal, cooking one part every morning. Salt it well, and pour on it one-seventh part of the molasses—that is for your breakfasts. Use one loaf of bread each day for supper. Come again next Friday and let me know the result.”
She promised to follow this written prescription, and did so. The ensuing Friday she again presented herself before me, looking less distressed having earned $1.70. She said she “was glad to have done so, as the children could eat more than the seventh part of the purchase, and it was hard for her to eat it herself and deny the children.” However, she had obeyed and was able to do more work having earned ten cents more that week, although she and the children “felt sorely the lack of tea.” I advised her to make a change in her purchases, spending the same amount of money for a fresh shin of beef and turnips or a salted shoulder of pork, and to use the ten cents for extra molasses.
After two weeks, she came again to report to me. The change in her appearance was remarkable, and her account of her children’s condition was good. Also, she had been able to earn two dollars per week, which, however, was the utmost she could do in the time she could spare from the family work. At the end of another two weeks she came to me and asked permission to give to her husband a share of the dinner on the coming Sunday. He had smelled the stew when occasionally coming home and desired to partake of it. It was therefore agreed that he should add fifteen cents as his share for the cost of the dinner, which he did, and when Christmas came, she told me had done so regularly every day for the previous three weeks.
I made them a Christmas present of a piece of roasting beef, fifty pounds weight of apples, and the same amount of potatoes, while former friends to whom I had spoken of their destitution, sent tea, sugar and milk, also shoes and stockings for the children.
After this sumptuous holiday feast, severely cold weather followed. Careless housekeepers in all ranks of life allowed their water pipes to burst, and great was the demand for plumbers’ work, especially in the suburbs of Boston. Mary’s former friends were willing to employ her husband again, under his promise of strict sobriety, as they would not risk the danger of house-burning by the carelessness of a tipsy plumber. Mary cooked him substantial dinners of the description given above, and he felt like a man again in his home.
Being skillful as a workman and very obliging in disposition, he gained friends while jobbing in the different houses. Those who had known him before encouraged him to persevere and finally persuaded him to remove to one of those suburban towns where his business would be in good demand and where he would escape from the temptation of eating house and drinking saloon. Meantime, Mary had learned good lessons during these sixteen weeks. She now knew how to provide and cook good, cheap and wholesome meals, and soon adapted herself entirely to such ways and means as his earnings would provide.
It is now 1896, and the twenty years are completed since the beginning of that time of misery in that family, who now own three houses, in one of which Mary’s husband carries on a fine, thriving business, over the entrance door of which may be read the sign “John Smith & Son.” Another house is occupied by them as a dwelling, and the third, an investment of their earnings, is rented to their daughter’s husband who is foreman in their business.
Their life is simple and plain but comfortable, and when I met Mary recently, she told me that she had taught all the children, two boys and two girls, how to cook and how to mend clothes, and with great pride she assured me that corned beef and cabbage is their favorite dish, “although the children will often make ice cream for Sunday dessert.”
| Buy 7 lbs. corned beef | $0.35 |
| 21 ” potatoes | .25 |
| 14 ” cabbage | .28 |
| 7 ” Indian meal | .21 |
| 1 qt. molasses | .15 |
| 7 loaves bread | .35 |
| Salt | .01 |
| $1.60 |
The second sketch alluded to (The Woman’s Journal, May 13, 1893) is:
Another True Story
Some years ago, the wife of a farmer living not many miles from Boston came to my office to consult me, because she feared she was suffering from a disease such as can only befall a woman and which she fully believed was “killing her by inches.” With sunken cheeks, dull eyes, sallow complexion, pale lips and no more flesh on her limbs than was necessary to make locomotion possible, the woman sat there and told of her ailments—sleeplessness, utter lack of appetite, backache, depression of spirits, etc.
After listening and taking notes of her story of misery, I made a careful examination and then told her that she was entirely free from all disease, but that she was simply worn out and needed six months of rest and good living.
She sighed deeply and said it was impossible to follow such a prescription as their pecuniary means would not permit it. She said further that their two children had outgrown the district school of the town, and she had, with true Yankee ambition, persuaded her husband to send them to a relative in the city that they might have the advantage of came, she told me he had done so regularly every extra dollar of their earnings, although from motives of economy, the children spent Saturday and Sunday at home.
She said she felt sure a tonic would restore her appetite, and that the relief to her mind in knowing that she was free from disease would aid in curing her. So, carrying in her hand the valuable recipe for a tonic which might or might not be of use, she left me, promising to report herself in ten days.
At the end of that time she appeared, looking more dejected and forlorn than at her first visit, so much so that I was startled, and thought that I had made a mistake in my diagnosis as well as in my prognosis. With sobs, she informed me that a great misfortune had befallen them. This statement at once explained to me her appearance.
It was at the time when the first Jersey cows were imported into this country from England, and they were held at a great price. She told me that her husband, about six months before, had invested all the money they had in the savings bank in the purchase of one of those valuable creatures. On the day following the woman’s visit to me, this precious cow had begun to be ailing. The trouble increasing, a veterinary surgeon had been consulted, and he told them if they would save the health and life of the cow, they must procure a faithful, intelligent man to take charge of her from morning to night. This sad event made it necessary for them to take for attendance on the cow the services of their best hired man, while the hiring of another man in his place would prevent their expending money for the charwoman who gave the good farmer’s wife an occasional lift with the housework. She sobbingly ended her story by saying, “I must work even harder than a week ago—you must give me a stronger tonic.”
The case looked so sad and hopeless that I sat silently thinking for a moment, when suddenly a bright thought sprang into my mind, and I said, “Why don’t you nurse that cow and let the charwoman do your work in house, kitchen and dairy?”
As when a sunbeam bursts through heavy black clouds, so did a light flash over her face and into her eyes as I said these words; but in a moment it darkened down again as she began to think of all the objections to such a plan. But the idea was born; it grew; and with my vivid power of imagination, I overthrew all her objections one after another, until her conversation became really animated, and the plan appeared so plausible to both of us that the good woman went out of the office with no stronger tonic than hope and courage can bestow.
The whole affair was forgotten by me in the pressure of business and in listening to more stories of moral and physical misery. The summer with all its joy and beauty slipped away, and brilliant October brought a new flood of professional business and cares.
On one of these autumn days, a plump, sunburnt, cheerful-faced woman entered my sanctum, holding in one hand a huge bouquet of gorgeous dahlias, in the other a little jar of cream, and on her arm hung a small basket with a dozen fresh eggs.
“Don’t you remember me?” she said. Of course I did not, although the voice was familiar.
“Well, I am Mrs. F——, whom you advised to nurse her cow.”
I could hardly believe my eyes, even after her repeated assurances of her identity with that miserable wreck of the May before. She gave me an animated description of what followed her leaving my office; of all her doubts and misgivings during her journey home as to what her husband would say to such a proposition for both a sick wife and a sick cow; and of how she had timidly introduced the subject to him by telling him that I was a queer doctor who did not believe much in medicine.
All this prepared him for the account of my plan to which contrary to his usual habit when women proposed anything, he listened gravely, and then said thoughtfully, “Well, my dear, we might try it.” She at once called in the charwoman who had supplied her place that day and made arrangements with her to come daily.
The next morning she went to the field, with her rubber waterproof, her husband and the cow. The latter was tied to a stake, and my patient seated herself near on the waterproof (as I had suggested to her) while she watched the cow and petted and talked to her. The two took kindly to each other. One day’s experiment proved that she could keep the cow in such subjection and quietness as the surgeon had ordered, plucking the fresh grass for her and feeding her as needed. All went well. Let me give a part of her story in her own words:
“My husband was satisfied with the first day’s result, and made the few arrangements necessary. And you, Doctor, ought to have seen me as at sunrise, day after day, rain or shine, I walked to the pasture, with a big basket on my right arm full of my mending work; in my right hand a large white umbrella which my husband had bought for me; and in my left hand the rope to which my bossy was tied, and which, by the way, I did not need after a fortnight, she following me at my call and lying close beside me when not walking a few steps for a bite of the rich grass.
“My charwoman brought me all my meals and a pail of water for bossy. I soon had a keen appetite, almost impossible to satisfy; even the abundant provisions brought me and eagerly eaten with such good relish still seemed to leave a hollow unfilled; and after my walk home at sundown, I slept sweetly as I had not done for months.
“The cow got well; she is now followed by a strong, beautiful heifer six weeks old for which my husband has already had an offer of just half the money that he paid for the cow. And I—I feel strong, well and happy, can do all my work, and have taken none of the tonic. Besides all this, both my children are equally well, because when they came home for their weekly sojourn, they felt that they must spend Saturday and Sunday out in the field with poor mother who had no other diversion than the company of a cow. I really believe that their being with me out of doors has done them more good than they would have got from the change we had planned for vacation, a visit to relatives up in the mountains.
“So I thought I had better come and tell you of all the good you have done to our whole family by your excellent advice, although it seemed so queer to us all and, you may well believe, to our neighbors too.”
“How many months did you do this?” I asked. “Was it not tedious to be all day in such dull company?”
“I did this same thing,” she replied, “every day, from the time that I left you until the calf was three days old. And as for tediousness or loneliness, I never felt it, for I have done a heap of sewing, old and new, which had been accumulating during the past year when I could not sew because I was so miserable. Besides, I always took some reading matter with me, especially on rainy days when I could not use my needle. And as my bossy liked to have me talk to her, I read aloud the Boston Journal and our town paper. These she seemed to enjoy as much as my chatting with her, even when it came to the obituaries, death notices and quack medicine advertisements.”
She assured me that she had not had a single cold, although she had several times been drenched by thunder showers that had overtaken her when she was unprotected. She said also that she had learned the great lesson of the folly of carrying self-neglect and self-sacrifice to such an extent as to bring trouble not only on one’s self but also on all the family.
If this little tale should be read by the family described, I wish one of them would send name and address (which I have no right to betray) to the Woman’s Journal.