Read The Nightingale Shore Murder Online
Authors: Rosemary Cook
Towards the end of the War, the enormous contribution of VADs, in both field hospitals and the temporary hospitals set up in country houses in England, was widely recognised. A BJN editorial reported in July 1918 on a procession of women war workers to pay homage to the King and Queen on their silver wedding anniversary, which was received by the Royal Family in the quadrangle of Buckingham Palace. It must have pained Bedford Fenwick to record that:
âV.A.D. workers took precedence of all other branches of women's work, including the Trained Nurses of the Metropolitan Asylums Board⦠Referring to nurses and V.A.D. workers His Majesty said, “They have often faced cheerfully and courageously great risks, both at home and overseas, in carrying on their work, and the Women's Army has its own Roll of Honour of those who have lost their lives in the service of their country. Of all these we think to-day with reverent pride.”'
The admiration expressed by the King (and the Red Cross, the Order of St John and the country at large) for the VADs did not change Bedford Fenwick's view of them, or her conviction that they constituted a threat to âproper' nurses.
âOwing largely to the glorification of the semi-trained war worker by the Nurses' Department in the Red Cross Office,' she wrote in 1918, âcompetition with the certificated nurse has already become a serious menace to our professional ideals.'
A Bill to introduce registration for trained nurses was finally passed in 1919, with Bedford Fenwick sitting in the public gallery of the House of Commons to see it. When the Roll of Nurses was opened, she was entered onto it as Registered Nurse No 1.
With her Parliamentary connections, it is possible that Bedford Fenwick had some influence on a written Parliamentary Question put by Brigadier-General Croft, MP for Bournemouth, the following year.
â[He] asked the Secretary of State for War whether his attention has been called to the fact that a great many trained nurses who served as nursing sisters on active service continuously from August, 1914, onwards have now been released from service without any official expression of gratitude for their services; whether he is aware that several cases of nurses who were recommended in the strongest terms by their commanding officers for the Royal Red Cross, First Class, in recognition of exceptional services in the actual war zone, have been passed over, whilst nurses in many cases untrained, and who never left Home duty, have received this honour; and whether, in view of these facts, he will cause inquiry to be made with a view to securing justice to those who have been strongly recommended for this honour.
Mr. CHURCHILL
All trained nurses who served under the War Office as nursing sisters on active service have, on being demobilised, received an official letter conveying thanks for their services. Recommendations for the award of the Royal Red Cross, whether at home or abroad, are in all cases made by the General Officer Commanding under whom the person recommended has served, and so far as I am aware there have been no cases in which nurses serving abroad, who have been so recommended, have not been given the decoration.
Florence finished her army nursing service working on No 5 Ambulance Train in 1919, taking wounded Germans back to Cologne. Here again she shared the experience with Sister Kathleen Luard, who wrote about their work in her diary:
âImagine a hospital as big as King's College Hospital all packed into a train, and having to be self-provisioned, watered, sanitated, lit, cleaned, doctored and nursed and staffed and officered, all within its own limits. No outside person can realise the difficulties, except those who try to work itâ¦
Three trains full of wounded, numbering altogether 1,175 cases, have been dressed at the station today ... the train I was put to had 510 cases ...the platform was soon packed with stretchers with all the bad cases waiting patiently to be taken to the Hospital... The staple dressing is tincture of iodine; you don't attempt anything but swabbing with Lysol, and then gauze dipped in iodine. They were nearly all shrapnel shell wounds â more ghastly than anything I have ever seen or smelt; the Mauser wounds of the Boer War were pin-pricks compared with themâ¦
They were bleeding faster than we could cope with it; and the agony of getting them off the stretchers on to the top bunks is a thing to forget. We were full up by about 2am, and then were delayed by a collision up the line, which was blocked by dead horses as a result⦠the head cases were delirious, and trying to get out of the window, and we were giving strychnine and morphia all round. Two were put off dying at St Omer, but we kept the rest alive to Boulogne.'
Florence was awarded the Royal Red Cross medal, created by Queen Victoria in 1883, for her work during the War. The decoration, in the shape of a cross enamelled in red and gold, with a medallion in the centre bearing the head of the reigning monarch, was intended for â
any ladies, whether subjects or foreign persons, who may be recommended by Our Secretary of State for War for special exertions in providing for the nursing of sick and wounded soldiers and sailors of Our Army and Navy
'
.
*
Florence's godmother, Florence Nightingale, had been the first recipient, for her work at Scutari hospital in the Crimea. Receiving the Royal Red Cross made Florence Shore automatically eligible for the French Croix de Guerre as well. But Florence never received her Red Cross medal. She was due to be presented with it by the King at Buckingham Palace in March 1920; but by then she was dead. The decoration was sent instead to her brother Offley in California. She did receive other medals â the QA Star, British War Medal, Victory medal and her French war medal â all of which are now in the Florence Nightingale Museum.
*
Florence was demobilised at the beginning of November 1919. On 27
th
October, she moved to the nurses' hostel at Boulogne. She signed a form on 1
st
November declaring that her military service had not rendered her disabled, and received her Dispersal Certificate indicating that she would be disembarking at Folkestone on 3
rd
November. She would be proceeding to Hammersmith in London, and her formal date of dispersal was 11
th
November 1919. After five years of extreme danger, considerable privations and long exposure to all the horrors of war, Florence returned to Carnforth Lodge to be reunited with Mabel and the nurses of the Hammersmith and Fulham District Nursing Association. The Lodge would prove to be her last home: she would live there for just eight weeks.
The Army nurses had returned to a very different England. Women had replaced men in factories, on railways and in some police forces at home, while the men were away; and they had nursed, and some had died, on battlefields, trains and ships in the war zone. Girls who had grown up with the still strict protocols of Edwardian England found freedom in the wards, tents and hospitals of Europe and beyond, which could not be easily laid down. The end of the war was the beginning of new era in the development of women's role in society: Florence and her colleagues stood at the threshold of a new phase of their personal and professional lives. But she would not go forward with them.
She had returned to find the country in the grip of a fearsome winter â one night the temperature plunged to minus 23 degrees â and ravaged not only by war, but by the world-wide pandemic of influenza. The âSpanish flu' had killed tens of thousands more people than the whole four years of war; and its British death toll included some of Florence's fellow Queen's Nurses, who had died whilst nursing its victims.
âI have nursed most infectious and contagious illnesses mentioned in text-books,' wrote Ellen Hancox, Superintendent of the Sheffield District Nursing Association in 1919, âbut I have never seen anything to equal this most horrible complaint, the complications of which baffled the skill and ingenuity of the most experienced. In some instances the mental condition of the patient was not only a thing to be dreaded but was beyond all description, the language and behaviour being what one would expect to find only in the most depraved.
In some cases the eyes swelled and burst, and the patient died after acute suffering. In others there would be an acute form of stomatitis [inflammation in the mouth], the tongue, uvulae and soft parts sloughing away, in spite of most constant and careful treatment.'
What Miss Hancox was describing was the deadly influenza epidemic that swept around the world between 1918 and 1920. It became known at the time as the âSpanish flu': not because it originated in Spain, but because the Spanish press, unconstrained by wartime censorship as other countries were, reported it more thoroughly. As it coincided with the final year of the First World War, many people were suspicious of the sudden arrival of such a virulent killer disease. In the United States, where the flu broke out first in huge military training camps, there were rumours that plague germs had been inserted into aspirin tablets made by a German pharmaceutical firm; that it had been brought into Boston harbour on a German ship; or that the Germans had released vials of the germs in American theatres.
In fact, the Germans were suffering just as badly, with what they called âFlanders fever'. It had started in Spring 1918 with a more normal flu outbreak. The British army called it âthree day fever', and treated the sufferers alongside the wounded in their hospitals. But the second wave of the epidemic was different. It was much more virulent, infecting a large percentage of the population. In the US, 28% of the population became ill, with 40% of the navy personnel and 36% of the army succumbing. While the first wave of the flu had mostly bypassed Africa, South America and Canada, the second did not. By August it had affected India, South East Asia, Japan, China and Southern and Central America. It peaked in England in June. Worldwide, it is estimated that up to one third of people caught the disease.
The second wave also killed a much higher proportion of its victims: it is estimated that this flu killed 10-20% of the people who caught it. The toll of world-wide deaths is reported very variably, at figures from 20 million to 100 million â in comparison, total deaths in the First World War (military and civilian) were around 15 million.
There were no antibiotics or effective flu vaccines to help the sufferers or protect the population. Vaccination was tried using bodily fluids from sufferers injected into healthy people, but did not work. The only way to try to contain the spread of the flu was through public health and control measures. Many countries banned public meetings and closed theatres. Others introduced byelaws against spitting and coughing in public, or enforced the wearing of gauze masks by anyone out in public. There is a famous picture of an American baseball game in progress with every player and everyone in the crowd wearing masks. While the number of sufferers climbed exponentially, the most important tasks were the nursing of the sick, and the removal and burial of the dead: and there were barely enough well people to do this.
âAs several of the nurses were away for their holidays', Ellen Hancox wrote, âwe were short of staff, and it was with greatest difficulty that we were able to cope with the rush of work. In many instances every member of the household would be ill in bed, and often the doctor who should have been in attendance was incapacitated as well. Some of our experiences at this time were tragic to a degree, but bad as they were they were nothing to what we were to experience later. No one who had anything to do with nursing or visiting the sick will ever forget the closing weeks of September and the months of October and November, with one special time which marred Victory week for so many Sheffield people! For it was not possible to enter into the spirit of such rejoicing when those one loved were either dying or lying dead in the house. At one time it was only on very rare occasions that we entered a house which had not been visited by the Angel of Death, and we frequently had to superintend the removal of the dead from the bed before we could start nursing the living.'
Superintendent Hancox also noticed the different and alarming nature of this flu pandemic:
âAll three epidemics proved disastrous for expectant and young mothers. Old people and young children generally recovered, while young working people from about 18 to 30 years of age died in most extraordinary numbers. In Sheffield a peculiar fact was noticeable, namely that districts in the highest parts of the City (and Sheffield is very hilly!) suffered more acutely than those on the lower areas.'
The speed with which the illness developed and often killed its victims was also apparent, and astonishing, to this experienced nurse:
âAlthough we always visited every patient as soon as possible after the case was sent in (we have a reputation for being extremely prompt) we often found them dead when we arrived. One of the big firms asked for a nurse to visit the wife of one of their workmen. The case came in rather late in the morning, so I went myself, early in the afternoon, and found the father, mother, husband and four children had all died in about a week, the wife and her sister being the only two of the family left. This woman was a widow for a second time, her first husband having been killed some months previously. When I saw her, she was in a state of profound coma, with a temperature of 106. However, she ultimately recovered.'
Miss Hancox finished her article with âgreat praise' for the people who had come forward voluntarily to help the over-stretched district nurses and doctors. She reports that the wives of some of the prisoners of war did â
most valuable nursing work in looking after the families of the stricken sick people'
. And in November, the Committee of the Sheffield District Nursing Association passed a vote of thanks to the nurses â
congratulating them on the splendid way they had risen to the occasion
.'
Similar reliance on volunteers and heroic efforts from health professionals was taking place in Leicester. Miss M Knox Mearns described how her nurses â
struggled along for the first fortnight in October without any extra help, all the staff working from nine to eleven hours a day',
until the local Medical Officer of Health closed the schools, and the school nurses and health visitors swelled the ranks of the district nurses. He also appealed in the local newspapers for help in the homes of the sick, and the response was âfairly good.'
âIt was a great boon to be able to send help to those very sad cases where all in the house were ill, some dead and others dying', Miss Knox Mearns wrote to the Queen's Nurses' magazine. âThe majority of helpers were just splendid. They did not mind what they did â scrubbing floors, washing clothes, cooking food etc â was all one to them... Fortunately only four of my own nurses had influenza, and that very lightly, but I was not so fortunate in those sent to help; every day or two one dropped out, until at the end of a fortnight only two were left.
All the organisation was done from the Home, and it entailed a great deal of hard work, as new cases were always coming in and more help had to be arranged. We had more offers for day than for night work, consequently we had to move our night staff about, giving the staff a rest where it was most needed. We had a few men for nights also, and we were very glad of them for the delirious male patients.'
The Leicester District Nursing Association may have been relatively unscathed by influenza amongst its staff; but elsewhere the epidemic did claim victims amongst the Queen's Nurses, who were the mainstay of care for affected families. Early in 1919, the Council of Queen Victoria's Jubilee Institute for Nurses passed a unanimous resolution in appreciation of the âself-sacrificing and devoted services' done by Queen's Inspectors, Superintendents and Nurses during the epidemic. The Queen's Nurses' magazine reported the resolution, and a statement from the Council, under the heading âOur Roll of Honour':
âThe call came to them at a time when staffs were depleted, when no help could be had and when the workers were almost at breaking point, but they responded nobly. They had already struggled through four weary years, taking the places of those gone for âwar work', comforting the sad and sorrowing, tending the wives and children left behind and caring for the mothers and babies of the nation. Yet without hesitation, serenely, and as part of their day's work, they met the hourly increasing demands on their services and, putting aside their own weariness, fought against fearful odds, often with the doctor unable to visit except at rare intervals, often in overcrowded houses and insanitary surroundings, the dying and the dead together, and often until they themselves went down as victims to the fell disease. Death took a heavy toll, as will be seen below, and sadly will they be missed by many.'
The Roll of Honour starts with Margaret Carroll, a district nurse at Lawrencetown, Co. Galway for five years, who died of flu on 20
th
November 1918.
âShe did excellent work in the district, where she was beloved by all for her unselfish and untiring devotion to duty,'
the magazine records.
Alice Corns, who died of flu on 23
rd
November, had only just started at her district at Sale.
âAll those districts where she had worked will mourn her loss.'
Margaret Elliott died on 27
th
November from heart failure following influenza.
âShe was a capable unsparing worker, whose loss will long be felt amongst her patients in Willington.
'
Mary Jones, who died at Worthing on 30
th
October of pneumonia following influenza ,
âwas very much beloved by all her patients and friends, and her loss to the Association is a very great one, for she gave of her best at all times.'
Sarah Lake was Superintendent of the Hulme Home in Manchester before she died on 9
th
December, â
and a most successful and useful career in the nursing profession is thus brought to a close. She will be a great loss to the community and is deeply mourned.'
Dorothy Pond, who was on military nursing service, died on 30
th
October, after three days' illness, of pneumonia.
âHer loss is much deplored.'
Ann Sowerbutts passed away on 14
th
November, at Hayward's Heath, where, with the exception of a year on military nursing service, she had worked as a Queen's Nurse since 1913.
âShe won the hearts of all classes by her devotion to duty and her kindly bearing, and deep expressions of regret were heard on every hand when her death became known, while many eyes were dimmed with tears as she was borne to her last resting place.'
Mary Welch died on 27
th
November from pneumonia following influenza. â
She was a faithful and devoted nurse who will be greatly missed at Woolwich, where she was working as a Senior at the time of her illness and death.'
Two former Queen's Nurses, Charlotte Brooks and Annie Wood, who had recently returned to work on the staff of the Kensington District Nursing Association, were taken ill and both died on 8
th
November, from the effects of influenza.
âA short funeral service was held at St Mary Abbotts' Church, and this was attended by Members of the Committee and by friends of the Nursing Association as well as the Nurses in the Home.'
By the end of 1919, when Florence returned to England, the worst of the pandemic was over, though it officially ended in mid-1920. Mabel and Florence, and the nurses of the Hammersmith and Fulham District Nursing Association, had survived unscathed. With their education in germ theory and hygiene, and experience of nursing infectious diseases over many years, they may even have been able to laugh at an item reported in the Queen's Nurses' magazine in 1919 under the heading âSugar and Influenza':
âIn view of the gloomy anticipation of another influenza epidemic, prevalent in some quarters, it is interesting and cheering to see that Dr Soltau Fenwick, speaking in London on the subject the other day, gave it as his opinion that “the people who died last year from pneumonia following influenza, did so largely from heart failure due to insufficient sugar. Sugar and fat were essentials, and people were underfed especially in these two articles. This year there was no earthly reason why any influenza epidemic should find us ready to collapse.”'
But for Florence, there was little time left to enjoy the peace. She celebrated her 55
th
birthday on 10
th
January 1920. On 12
th
January, she stepped onto the train at Victoria Station for the journey to St Leonards and a holiday with friends, and was found barely conscious in her compartment two hours later. Less than three weeks into the new decade, Florence would be dead.