She became pregnant again, much to her dismay and to the great regret of her husband. At times she thought of abortion, but only in a desperate way. The last few months of her term were in the very hot months of the year and she was very uncomfortable. However, she was delivered safely, got up in a week to help in the care of her other two children and to get the house into shape again. Her milk was fairly plentiful, despite her fatigue and "jumpy nerves." Unfortunately at this time, when they had accumulated a little surplus and she was looking forward to better clothes for her family and more comforts, the plant at which her husband was employed suspended operations because of some "high finance" mix-up. Coming at this time, the news struck terror into her heart; she broke down, became "hysterical" i.e. had an emotional outburst. This passed away, but now she was sleepless, had no appetite, complained of headache and great fatigue.
Though she was assured that the plant would reopen soon (in fact it soon did), she made little progress. That she was suffering from a psychoneurosis was evident; what remained was to bring about treatment.
This was done by enlisting a development of recent days,—the Social Service agencies. Out of the old-time charity has come a fine successor, social service; out of the amateurish, self-consciously gracious and sweet Lady Bountiful has come the social worker. Unfortunately social service has not yet dropped the name "Charity", perhaps has not been able to do so, largely because the well-to-do from whom the money must come like to think of themselves as charitable, rather than as the beneficiaries of the social system giving to the unfortunates of that system.
Let me say one more word about social service and the social worker, though I feel that a volume of praise would be more fitting. The social worker has become an indispensable part of the hospital organization, an investigator to bring in facts, a social adjuster to bring about cure. For a hospital to be without a social service department is to confess itself behind the times and inefficient.
Briefly, this is what was done for this family.
Their prejudices against social aid were removed by emphasizing that they were not recipients of charity. The husband was allowed to pay, or arrange to pay, for a six weeks' stay in the country for the mother and the new baby. The home for this purpose was found by the agency and was that of a kindly elderly couple who took the woman into their hearts as well as over their threshold. The social worker arranged with a nursing organization to send a worker to the man's house each day to clean up the home while the children stayed in a nursery. One way or another the husband and children were made comfortable, and the wife came back from her stay, made over, eager to get back to her work.
It is obvious that in such a case as this the physician is largely diagnostician and director, the actual treatment consisting in getting a selfish and inert social system to help out one of its victims. That a sick man should be left to sink or swim, though he has previously been industrious and a good member of society, is injustice and social inefficiency. That a woman, under such circumstances, should be left with the entire burden on her hands is part of the stupidity and cruelty of society.
How avert such a thing? For one thing do away with the name "Charity" in relief work,—and find some system by which industry will adequately care for its victims. What system will do that? I fear it may be called socialistic to suggest that some of the fifteen billions spent last year on luxuries might better be shifted to social amelioration. The record in automobile production would be more pleasing if it did not mean a shift from real social wealth to individual luxury.
Case II. The over-rich, purposeless woman.
This type is of course the direct opposite of the woman in Case I and represents the kind of woman usually held up as most commonly afflicted with "nervousness." "If she really had something to do," say the critics, "she would not be nervous."