The house on Henry Street

by Lillian D. Wald

Despite the neighborhood’s friendliness, however, we struggled, not only with poverty and disease, but with the traditional fate of the pioneer: in many cases we encountered the inevitable opposition which the unusual must arouse. It seems almost ungracious to relate some of our first experiences with doctors. No one can give greater tribute than do the nurses of the settlement to the generosity of physicians and surgeons when we recall how often paying patients were set aside for more urgent non-paying ones; the counsel freely given from the highest for the lowliest; the eager readiness to respond. Occasionally sage advice came from a veteran who knew the people well and lamented the economic pressure which at times involved, to their spiritual disaster, doctors as well as patients.

The first day on which we set out to discover the sick who might need a nurse, my comrade found a woman with high temperature in an airless room, more oppressive because of the fetid odor from the bed. Service with one of New York’s skilled specialists had trained the nurse well and she identified the symptoms immediately. “Yes, there was a Lodge doctor.—He had left a prescription.—He might come again.” With fine diplomacy an excuse was made to call upon the doctor and to assume that he would accept the nurse’s aid. My colleague presented her credentials and offered to accompany him to the case immediately, as she was “sure conditions must have changed since his last visit or he would doubtless have ordered” so-and-so,—suggesting the treatment the distinguished specialists were then using. He promised to go, and the nurse waited patiently for hours at the woman’s bedside. When he arrived he pooh-poohed and said, “Nothing doing.” We had ascertained the financial condition of the family from the evidence of the empty push-cart and the fact that the fish-peddler was not in the market with his merchandise. Five dollars was loaned that night to purchase stock next day.

My comrade and I decided to visit the patient early the next morning, to mingle judgments on what action could be taken in this serious illness with due respect to established etiquette. When we arrived, the Lodge doctor and a “Professor” (a consultant) were in the sickroom, and our five dollars, left for fish, was in their possession. Cigarettes in mouths and hats on heads, they were questioning husband and wife, and only Dickens could have done justice to the scene. We were not too timid to allude to the poverty and the source of the fee, and felt free when we were told to “go ahead and do anything you like.” That permission we acted upon instantly and received, over the telephone, authority from the distinguished specialist to get to work. We were prudent enough to report the authority and treatment given, with solemn etiquette, to the physician in attendance, who in turn congratulated us on having helped him to save a life!

Not all our encounters with this class of practitioner were fruitful of benefit to their patients. Heartbreaking was the tragedy of Samuel, the twenty-one-year-old carpenter, and Ida, his bride. They had been boy and girl sweethearts in Poland, and the coming to America, the preparation of the clean two-roomed home, the expectation of the baby, made a pretty story which should have had happy succeeding chapters, the start was so good. Samuel knocked at our door, incoherent in his fright, but we were fast accustoming ourselves to recognize danger-signals, and I at once followed him to the top floor of his tenement.

Plain to see, Ida was dying. The midwife said she had done all she could, but she was obviously frightened. “No one could have done any better,” she insisted, “not any doctor”; but she had called one and he had left the woman lacerated and agonizing because the expected fee had been paid only in part. It was Samuel’s last dollar. The septic woman could only be sent to the city hospital. The ambulance surgeon was persuaded to let the boy husband ride with her, and he remained at the hospital until she and the baby died a few hours later.

Here my comrade and I came against the stone wall of professional etiquette. It seemed as if public sentiment ought to be directed by the doctors themselves against such practices, but although I finally called upon one of the high-minded and distinguished men who had signed the diploma of the offending doctor, I could not get reproof administered, and my ardor for arousing public indignation in the profession was chilled. Later, when I heard protests from employers against insistence by labor organizations on the closed shop, it occurred to me that they failed to recognize analogies in the professional etiquette which conventional society has long accepted.

However, many friendly strong bonds were made and have been sustained with a large majority of the doctors during all the years of our service. We have mutual ties of personal and community interests, and work together as comrades; the practitioners with high standards for themselves and ideals for their sacred profession comprehend our common cause and strengthen our hands. It is rare now, although at first it was very frequent, that the physician who has called in the nurse for his patient demands her withdrawal when he himself has been dismissed. He has come to see that although the nurse exerts her influence to preserve his prestige, for the patient’s sake as well as his own, nevertheless, emotional people, unaccustomed to the settled relation of the family doctor, may and often do change physicians from six to ten times in the course of one illness. The nurse, however, may remain at the bedside throughout all vicissitudes.

The most definite protest against the newer relationship came from a woman active in many public movements, who was a stickler for the orthodox method of procuring a visiting nurse only through the doctor. To illustrate the importance of freedom for the patients, I cited the case of the L⸺ family. A neighbor had called for aid. “Some kind of an awful catching sickness on the same floor I live on, to the right, front,” she whispered. A worn and haggard woman was lifting a heavy boiler filled with “wash” from the stove when I entered; on the floor in the other room three little children lay ill with typhoid fever, one of them with meningitis. The feather pillows, most precious possession, had been pawned to pay the doctor. The father dared not leave the shop, for money was needed, and all that he earned was far from enough. The mother, when questioned as to the delay in sending for nursing help, said that the doctor had frightened her from doing so by telling her that, if a nurse came, the children would surely be sent to the hospital. No disinfectant was found in the house, and the mother declared that no instructions had been given her.